TOFP

This past week I got a note from a friend of mine who has recently taken the plunge into minimalist running.

Her question was one of fear and high anxiety: "Have you ever heard of TOFP???"

Admittedly, I chuckled a little. I (very fortunately) had only 1 episode of TOFP (Top Of Foot Pain) and it freaked me out! I was terrified I had a stress fracture, that I was going to have to take tons of time off, etc.... in another words, I felt her pain.

I thought that I would repost my note to her on TOFP to share with everyone, as this is a very common thing. As I said, I only had one isolated episode of it (after running the "Suicide 5k" way before I was ready!) but many people have it recur several times. See my response below:

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Yes, I know TOFP (Top Of Foot Pain) and it sounds like what you have. TOFP is a result of another acronym: TMTS (Too Much Too Soon)

It's an adaptation of your feet - all those tiny bones, those ligaments, connective tissue, things you haven't used for most of your entire life. Think of it as physical therapy: when you have your leg in a cast for 3 months, all those muscles atrophy and you have to do physical therapy to wake those muscles back up and strengthen them. Your feet have been in casts your entire life - this is a slow process of 'rehabilitating' your feet to how you are using them now.

TOFP is experienced, to some degree, by about 80% of barefoot/minimalist runners. It is (I dare say) always a result of Too Much Too Soon. Here's what I suggest:

Basics:
Back your mileage down a little
Back your pace down a little
Always take a day of rest between run days
You have to take it easy and build up your running. it will take 3 months for your feet (and ankles and calves) to truly get 'used' to being used. In that time you have to take it slow. It feels so good and it's so much fun it's hard to take it slow, but remember, this is your physical therapy - ease in!
Take about 5 days - week off Now (no running of any kind).

Also:
Relax! Tense feet and tense ankles can exacerbate TOFP, be as loose and relaxed as possible - no muscles should be tensed.
Your calves being tight (connect) also can cause and make TOFP worse - focus on stretching your calves (the better you stretch your calves, the better it will be, the faster you will recover)
Also, make sure your VFF straps aren't pulled too tight - you want them loose, they don't need to be tight on top, the strap really isn't necessary at all.

I.C.E.
Ice your foot (30 minutes at a time)
Elevate your foot (while you ice it - just prop it up above your heart, i.e. lay down on your back on the couch, put your foot up on a couple of cushions, and ice it there for 30 minutes)

Aspirin:
Take something with aspirin in it (anti-inflammatory): like Aleve (Not Tylenol)