Metatarsalgia, what?!

If you’ve never been to the doctor for your feet or aren’t in an anatomy class, you’re probably wondering, what is metatarsalgia. On the other hand, you may have come across this page because you have just seen your doctor and they said you had it. You may not be familiar with the term but you may be very familiar with its symptoms:

  • Ball of foot pain behind the toes
  • Calluses on your ball of foot
  • An abnormal bend in your toes making your toes look like a hammer, which is called hammertoe
  • Inflammation in your joints in the back of the toes.

Any of these symptoms sound familiar?

If you look down at your toes, you’ll notice that the big toe is larger. The bone behind that toe is actually the largest as well at about two times that of the others. These bones behind your toes are called metatarsals. You have much more control and movement of the metatarsal of the big toe than the other ones. Your fourth and fifth toes have a bit more motion than the second and third as well. This is by design!

Our feet are the only body part that is required to bear the weight of our entire body. It is no wonder that when our feet aren’t functioning by its very design, it can cause pain upward through the rest of the body. It’s much like a domino effect where one thing leads to another. In the same way, when your big toe joint is unable to move upward during walking or running, then that bone that sits behind the big toe is unable to move downward. This causes the stress to transfer to the smaller second and third metatarsal bones. This pressure can cause calluses, hardened skin or other problems as mentioned before like hammertoe and inflammation, and pain. Essentially, the body is trying to signal to you that something is wrong. We’re sure you recognize it too because this will trigger your pain sensors. When this happens it is impossible to walk correctly.

Unfortunately, many of the products that are available today merely treat the symptoms and do not treat the root cause of the problem. You guessed it, the immobility of the big toe. The big toe and it’s associated metatarsal is the bone large enough to bear more of your weight as you spring off of it towards your next step. If you’re having issues with your second and third toe, most likely this is indicating that they’re trying to bear the weight that they were never meant to bear!

This condition may be more likely to develop if you:

  • Do a lot of standing in one spot during the day.
  • Work in a small space and walk with a shuffle during the day.
  • Wear shoes that are too stiff or shoes that cramp your toes together.
  • Have poor foot posture and roll your foot into the inside too much.
  • Have a lot of muscle tightness.
  • The great news is surgery is rarely needed with this injury.

Take for example a customer we heard from recently. He lives in the UK and he is a master level (older), runner. He is the best runner in his age group in the UK in the 400m. He had significant pain in the back of the second toe for a number of years and has tried various insoles, metatarsal pads and shoes to alleviate the problem. The problem is that motion in his big toe joint was restricted and none of these pads or insoles or shoes could solve the problem. When we restored the ability to extend the big toe and allowed his first metatarsal to come down and bear the weight it is designed for, his pain was completely alleviated.

Now that we’ve unpacked metatarsalgia, can you see why it’s just a big word for a ball of foot pain?

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