Metatarsalgia

The metatarsals are the five long bones of the foot. Athletes who run and jump a lot may be susceptible to metatarsalgia or stone bruise, a condition that manifests itself in pain and inflammation in the ball of the foot. The second, third and fourth metatarsal heads (the ball of the foot behind the toes) are the regions most affected. Wearing shoes with soles that are too thin for the activity can lead to metatarsalgia.

Other causes of metatarsalgia:

• Over-pronation of the feet (the foot rolls inward and the toes point outward)
• A tight, high foot arc
• A shortened first metatarsal which puts too much pressure on the second metatarsal
• Tightness in the tendons that straighten the toes
• Wearing high heels or poorly-fitting shoes that prevent the toes from lying flat. Hammertoe and bunions can result, leading to metatarsalgia
• Excess weight puts more pressure on the metatarsals
• Intense training or activity

Signs and symptoms

• Pain in the forefoot is most pronounced when the person tries to bear weight or push off in high heels
• Passive range of motion (when the therapist tries to bend the foot downwards) may be difficult or painful
• Pain and tenderness when the joint is pressed in
• Excessive skin or calluses may be seen under the foot because of pressure

In treatment, we can assess gait and help you correct uneven distribution of pressure on the metatarsals - which frequently involves recommend properly fitting shoes or fitting you with doctor-prescribed orthoses to correct over-pronation. We may train you in stretching and strengthening exercises to correct tightness in the tendons. Massage to relieve pain and tightness in the metatarsal area is also a common treatment.

Although not a very serious condition, metatarsalgia can sideline you for a considerable length of time and, if left untreated, can lead to pain in the other foot or lower back pain because of your altered gait. It is necessary to see your physiotherapist early in order to stave off further problems. Call Lambton Physiotherapy and Sports Medicine today.