Does the ball of your foot feel like it’s on fire? Does it feel like there’s a big, painful lump under your toes? Does it hurt most after you’ve been on your feet a lot? If so, you may be suffering from Metatarsalgia.

What is Metatarsalgia?

Each time you step down on the ball of the foot the metatarsal arch begins to flatten. This allows the metatarsal arch to act as a shock absorber. As we step forward all of our body weight is forced onto the toes and balls of the foot. If they are not aligned or supported properly, or if we have insufficient fatty padding, we experience pain. (Click here to learn more about the Metatarsal Arch.)

Sometimes we create a metatarsal pain unkowingly by wearing:

• High-heeled shoes
• Shoes with restrictive, narrow toe box
• Poorly padded shoes, like work boots
• Sandals or shoes with flat insoles (little or no arch support)

Other times Metatarsalgia is the result of bad genes or injuries, such as Dropped Metatarsals or a thinning or destruction of the fatty pad in the ball of the foot.

Dropped metatarsal – Each foot has five metatarsals that connect to the toes. If one or more of the metatarsal heads sits lower than the others, it will bear more of our body weight than it should. Causes of a dropped metatarsal include:

• A “flexible foot” where the ligaments, tendons and muscles are too lax to hold the bones and joints in their optimal position.
• High heeled shoes which raise the heel, throwing the weight forward onto the ball of the foot. The increased weight and pressure stretches the soft tissues allowing the metatarsal head to drop.
• Injury such as fractured bones or dislocated joints that are not properly treated and may heal in an abnormal position. One common injury is called “March Fractures” derived from military recruits who exhibit this type of fracture. “March Fractures” are also common in runners, joggers, and other athletes.

Thinning or destruction of the fatty pad in the ball of the foot – The fatty pad acts as protection for the interior structures of the foot.

• A dropped metatarsal will destroy the fatty pad between it and the skin.
• Some diseases cause thinning of the fatty pad including rheumatoid arthritis, connective tissue disorders, and endocrine disease.
• Excessive or prolonged pressure on the ball-of-the-foot such as that caused by high heeled shoes, walking barefoot, or wearing shoes with thin soles.
• Feet with high arches, which are usually rigid and don’t allow the arch to come down and contact its support. This causes all of the weight to be forced into the ball-of-the-foot, instead of some of the weight being carried by the arch. People with high arches need adequate arch support in addition to metatarsal support.
• Hammertoes create metatarsal pain when the toes contract and rise up in an effort to grip the ground due to a lack of balanced support from the metatarsals. Proper support gives the gripping toes a chance to relax.

Fortunately there are ways to relieve the pain caused by Metatarsalgia and it’s co-conspirators hammertoes and plantar fasciitis. Many of them can be found here at Happy Feet Plus. Look for footwear with good arch support, especially good metatarsal arch support, like the entire family of Birkenstock footwear as well as Finn Comfort. You can also purchase the Birko-Sport 2-part insole for use in your exisiting shoes (not your high heels though – there is no help for them.)

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Regards,

Dave