Keeping Your Feet Healthy

Healthy View

Written by: Peter Charbonneau, Consulting Canadian Certified Pedorthist, Adelaide Clinic & Sport Medicine Clinic

As we all fought through COVID-19, our living and exercise habits evolved. Our neighbourhoods and favourite walking trails became mini highways of people seeking fresh air and exercise, and those wanting to improve their mental health. Unfortunately, like many other activities, overuse conditions can surface. These cause aches and pains in areas that you may have never experienced before. A common injury of the foot is called Metatarsalgia.

Metatarsalgia is a general term used to denote a painful foot condition in the metatarsal region (the area just before the toes, often referred to as the ball-of-the-foot). Metatarsalgia is usually located under the 2^nd, 3^rd, and or 4^th metatarsal heads.

Cause:

With this common foot condition, one or more of the metatarsal heads become painful and/or inflamed, usually due to excessive pressure over a long period of time. You may experience acute, recurrent, or chronic pain with Metatarsalgia. Poor foot function or dramatic increase in weight bearing activities can be the primary cause. If you over or under pronate the joints on the ball-of-the-foot, they receive excessive “shear force” loading as the metatarsal arch collapses. Thinning of the metatarsal fat pad and a short 1^st metatarsal can also be contributing factors. Thinned soled or very flexible shoes/boots can also be the cause.

Treatment & Prevention:

The first step in treating Metatarsalgia is to determine the cause of the pain. If your symptoms have resulted from increased walking, shortening your distance and taking days off between long walks or runs would be wise. Review your footwear as well. A traditional running shoe would serve as an excellent walking shoe. If snow and ice is under foot, wear a hiking style boot for support, warmth, and traction. The stiffer sole will further protect the metatarsals and reduce shear force properties.

If the problem does not resolve via modified activity and improved footwear, you may have a “mechanical” foot issue. Conservative treatment involves unloading pressure to the ball-of-the-foot. This can be accomplished with either off-the-shelf foot beds or prescription orthotics that usually feature a metatarsal pad. Icing the painful area and strengthening the intrinsic muscles of the foot can also be beneficial.