STEENWYK
Custom Shoes & Orthotics

Metatarsalgia

Metatarsalgia is a generic term for pain or discomfort in the forefoot (the ball of the foot). Generally, metatarsalgia is attributed to a drop or collapse of the metatarsal arch. The arch flattens and the bone ends move closer together causing the soft tissue to be pinched or trapped between the bones. With every step, the arch rises and falls causing repeated stress in the area.

Metatarsalgia can readily be treated with orthotics to alleviate pressure in the area and ‘create’ a metatarsal arch. It is also important to decrease the pressure on the ball of the foot by lowering heel height and having a flexible ankle joint.

How would Foot Orthotics help?
Custom made foot orthotics are designed to correct or control biomechanic inefficiencies in the feet, legs or joints. Orthotics can help to support the dropped metatarsal arch and reduce the pressure in the ball of the foot. Orthotics also control excessive movement of the foot and ankle joints, reduce pronation and provide cushioning to protect the feet.

Associated Metatarsal Conditions
Neuromas
Neuromas commonly occur when the metatarsal arch drops and pinches a nerve between the bones.
The nerve becomes inflamed and the nerve tunnel becomes crowded. This causes tingling and numbness into the toes. Neuromas are most often located between the first and second or the third and fourth metatarsals.

Sesamoiditis
Sesamoiditis is the inflammation of the soft tissue surrounding the seed-like sesamoid bones in the ball of the foot under the big toe. This area becomes inflamed under pressure and can cause a shifting of the sesamoids. The irritation is very localized and is pressure sensitive.

Exposed Bone Ends
The dropped metatarsal arch exposes the bone ends on the bottom of the foot and creates a pressure area (and often a callous) under the second, third and/or fourth toes. This can lead to skin breakdown, especially in diabetics and arthritics.

Symptoms of Metatarsalgia
Pain at the ball of the foot during weight bearing activities
Tingling/Numbness in toes
Sharp or shooting pain in toes
Aggravated when dorsiflexing toes
Callousing under 2/3/4th toes

What Causes it?
Shortened heel cord range (calf muscles are too tight)
Change in shoe heel height
Prolonged use of improper footwear  i.e. high heels, cowboy boots
Muscle imbalance
Strained arches - excessive pronation or supination

Treatment Options
   Orthotics- the most effective, permanent way to treat and to avoid re-injury (link to Orthotics)
    Stretching- decreases the likelihood of recurrence.
    Shoes- the correct choice of shoes can be effective treatment for padding and protecting heel
    Anti-inflammatory medicine -cortisone injection or oral anti inflammatory medication to relieve symptoms, but
        may not address source of problem
    Rest
    Icing - helps to reduce swelling, thus reduce internal pressure   
    Physical Therapy -Ultra sound/ Electrical Stimulation/ Paraffin/Deep Heat/Whirlpool
    Surgical intervention

Giving your injured foot a hand!
Give your foot a rest.  If you’ve just started to get a tender spot, you may get over it in a few weeks. If you’ve had pain for
    a while, don’t expect an overnight recovery. If it took 2 years to develop, it may take two years to fully recover.
Cut down or cut out running and extended walking to rest the foot, or try other forms of exercise. Simply varying
        your workout with a less foot-dependent sport (e.g. swimming or cycling) might be all you need in the early stages.
Non-steriodal anti-inflammatory (e.g. acetominophen or aspirin) can help reduce inflammation thereby decreasing pain. Massage the area with ice. This is another good way to reduce inflammation. Once or twice a day for no more
        than 20 minutes at a time should be sufficient.
Stretch your calf muscles. Crazy as it sounds, this works! If the calf muscle is not flexible, the heel actually lifts into the
        air earlier than normal when walking. This means you are standing and walking on your toes most of the time, stressing
        the metatarsals. A relaxed tendon and calf muscle puts less strain on the injury.
Wear shoes with a moderate heel height. We recommend a heel height of 1/2" to 3/4". A lower heel height tightens the
        Achilles tendon. This will help handle the symptoms but will not fix the problem.

What is an Orthotic?
An orthotic is a custom made device that controls the amount of excessive pronation and supination that a foot goes through when walking, running or cycling. Runners will often say they are a pronator or a supinator. All people naturally pronate and supinate but excessive movement either way can be problematic.
(For more information, follow link to Orthotics, Types of Orthotics)

What is pronation and supination?
In simple term pronation is the flattening out of the arch when the foot strikes the ground. Normally, the foot will pronate to absorb shock when the heel hits the ground, and to assist in balance during mid-stance.

Supination is the opposite motion of pronation. It allows the foot to be a more stable, rigid structure for when we push off on our next step. The foot naturally supinates during the toe-off stage (when the heel first lift off the ground until the end of the step) to provide more leverage and to help ‘roll’ off the toes.
(For more information, follow link to Pronation and Supination)

Back to Common Foot Conditions

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STEENWYK
Custom Shoes & Orthotics

7727-50 Avenue    Red Deer, AB T4P-1M7     Canada     
Tel: (403) 340-0066    Fax: (403)340-0067
e-mail:   steenwyk@steenwyk.com