- The metatarsal region of the foot, commonly referred to as the forefoot or ball of the foot, consists of five long bones (metatarsals).
- One end connects to create the midfoot joints (tarsometatarsal joints) and the other end meets with the base of each toe (metatarsalphalangeal joints).
- Irritation of this area of the foot is commonly referred to as metatarsalgia.
What Do the Metatarsals Do?
- The shape of the metatarsals are important and is what forms the arch of the foot at the TMT joints, allowing the body to tolerate weight bearing activities such as walking.
- With the help of the tendons, muscles, and connective tissue, the metatarsal region is responsible for absorbing shock forces and aiding in weight transfer through the foot.
- The arch is a framework for balancing forces in the foot, particularly forward to the forefoot and backward towards the heel bone.
- During ambulation, the second and third metatarsals take most of the transfer of forces while rolling through and eventually transferring most weight to the first metatarsal and big toe.
How Does Metatarsalgia Happen?
- Anatomical abnormalities of the metatarsals
- High arches
- Asymmetrical length of metatarsals (second toe longer than first)
- Callusing in forefoot that creates pain
- Hypermobility of first toe
- Stress fractures causing abnormal gait pattern
- Excess weight causing more loading onto forefoot
- Morton’s neuroma
- Chronic use of tight fitting shoes that create compression on the forefoot
- Chronic use of loose fitting shoes causing increased sliding and friction leading to callus formation
- High heeled shoes cause increased mechanical load onto forefoot (75% more pressure on forefoot).
- Repetitive distance runners, high impact athletes due to the extra stress on the forefoot
- Pain in the ball of foot
- Tingling, numbness, and shooting pain in toes
- Pain worsens with activity and improves at rest
- Feeling of a lump or fullness in the forefoot