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Forefoot Pain


Metatarsalgia and Morton's Neuroma:
Here we will explore two conditions of the forefoot which can affect runners. Metatarsalgia is an inflammatory condition of the metatarsal heads (where your toes attach) of the foot while Morton's Neuroma is a fibrosis around the neurovascular (nerves and blood vesseles) bundle of the nerves that supply the toes. Both cause pain in the forefoot region, but they have different presentations. Some authors argue that Metatarsalgia should refer specifically to forefoot pain due to abnormal biomechanics of the foot, while others suggest that the term be used to lump together any and all conditions of the forefoot, which would include Morton's Neuroma.

Morton's Neuroma (swelling of the nerve) typically presents as pain or numbness in the bottom of the middle-to-outside of the forefoot which often shoots into the 3rd and 4th toe. Pain can be burning or sharp and agonizing.

With metararsalgia you get a bruised feeling in the ball of your foot. Metatarsalgia is most often a result of faulty distribution of weight on the forefoot. Normally, the little muscles that run between the bones of the feet contract during the final phase of each step to prevent the forefoot from splaying (widening) and the toes from curling. If these little intrinsic muscles don't do their job, the forefoot spreads and the toes curl which causes the metatarsal heads to be forced down and they contact the ground harder and this can lead to injury.

Conservative treatment incluldes ice, ultrasound and to address the mechanics of the feet. It may be necessary to look into orthotics to correct a biomechanical problem of the foot.

 

 
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