A number of foot and ankle problems can occur over the course of a 26-mile marathon. Perhaps the most detrimental is a fracture of one of the foot bones, which can knock a runner out of commission for an extended period. For runners, bone breaks are frequently a result of overstressing, and they should take care to address any foot pain that arises. Pain could indicate a microscopic fracture that could progress to a more serious break without treatment. Pain in the second toe and in the heel is particularly likely to indicate a break.
To avoid these breaks and fractures, a marathon runner should complete every race and practice run in well-fitting shoes. The proper width is important to avoid sliding and pinching. If running is uncomfortable with the correct shoe, particularly if the discomfort is on one side of the foot or leg, a runner should consult with a coach or physician about a potentially uneven gait. The imbalance resulting from an uneven gait is a common cause of stress fractures.