Forefoot Disorders – Pain In The Ball Of The Foot
Forefoot Disorders: Metatarsal pain (ball of the foot) and neuroma and Morton’s neuroma (Pinched nerves)
The human foot is extraordinary. Most people walk an average of 100,000 miles in a lifetime. In addition, our feet absorb approximately 400,000 pounds of force each day! (Force= Mass X Acceleration) That is the same force as a 6000-pound car smashing into a solid wall at 67 miles per hour! (This example is for a 150-pound person that walks one mile in an average day at 2 miles per hour). The more weight and speed increases the force proportionately. When you are wearing flat shoes 50% of your body s weight is on your heel and 50% is on the ball of your foot. When wearing heels over 1-1/2 90% of your body s weight is on the ball of your foot! No wonder heels hurt. Each foot contains 26 bones, 2 sesamoid bones, 29 joints, 42 muscles and tendons, 14 ligaments, and 13 miles of blood vessels and nerves. The shoes and supports are the only interfaces between our feet and these tremendous forces and miles put upon them. With poor biomechanics and improper fitting shoes, imagine the consequences. However, shoes and orthotics can improve your biomechanics. When your feet feel good, you feel good all over.
INTRODUCTION “When my feet I hurt all over.”
Pain in the ball of the foot is normally one of two things: First is metatarsalgia. It is inflamation of the metatarsal heads. It is usually felt in the ball of the foot and sometimes feel like “walking on small rocks”. Other people feel a more diffuse vague pain, aching or burning. Some people have trouble around only one or two toes, others have it throughout the ball on one or both feet. 90% of patients with metatarsalgia are found to be wearing shoes at least one size too small.
Secondly, inter-digital neuroma is a benign tumor that grows around the neurovascular bundle of the nerves that supply the toes. Almost 90% of all neuromas are found in females between the ages of 18 to 85 year old. Single neuromas are most common, however, instances of multiple neuromas in the same foot have been reported. Morton’s neuroma is the nerve found in between the 3rd and 4th metatarsals that supplies sensation to the third and fourth toes. There are a number of factors that can cause a localized irritation to the nerve and thus may contribute to the development of a neuroma, a benign tumor (thick scar tissue).
Contributing Factors
Shoes:
Any shoe that is high heeled or is constricting may place the individual at higher risk for developing a neuroma. Neuromas are commonly found in women who have worn high heeled shoes for many years or men who’s occupation require excessive stress of the forefoot such as kneeling or climbing ladders or are required to wear constricting shoes. Short shoes cause the toes to contract that cause the metatarsal heads to take an abnormal amount of weight causing metatarsalgia symptoms.
Biomechanical Abnormalities:
An unstable (pronated) flat foot can predispose the foot to the development neuroma and metatarsalgia symptoms. The excessive pulling on the common digital nerve against the deep transverse intermetatarsal ligament results in irritation and eventually the development of the neuroma. Also, a pronated foot causes the mid metatarsals to bear an overabundance of weight causing metatarsalgia.
Trauma:
Repetitive trauma that results from certain activities such as basketball, tennis, aerobics, running, etc., may precipitate the development of a neuroma and metatarsalgia. Trauma resulting from an injury such as fractures, sprains, dislocations, and crushing injuries may cause a neuroma and metatarsalgia.
SOLUTIONS
The first step in treating metatarsalgia is to determine the cause of the pain. If improper fitting footwear is the cause of the pain, the footwear must be changed. Footwear designed with a high, wide toe box (toe area) and a rocker sole are ideal for treating metatarsalgia. The high, wide toe box allows the foot to spread out while the rocker sole reduces stress on the ball-of-the-foot. Unloading pressure to the ball-of-the-foot can be accomplished with a variety of foot care products. Orthotics designed to relieve ball-of-foot pain usually feature a metatarsal pad and arch support to reduce the problems associated with a pronated foot. The orthotic is constructed with the pad placed behind the ball-of-the-foot to relieve pressure, and redistribute weight from the painful area to more tolerant areas.
What to expect
In a recent study done by the World Wide Orthopedic Foot & Ankle Society found 82% of the people that had neuromas or metatarsalgia were without pain by using bigger or wider shoes and an orthotic device. 92% were fine with bigger shoes, an orthotic device, and a cortisone shot. Only 8% of the population needed surgery. Most patients discovered significant relief within 4 to 6 weeks of shoe change and orthotic wear. Basically, shoes with plenty of toe room and metatarsal support should relieve most forefoot disorders. How your shoes should fit click here.
Sole Control shoes and orthotics to help pain it the balls of the feet in St. Louis, MO
Sole Control, Inc
9712 Watson Road
St. Louis, MO 63126
314-822-9494
solecontrolorthotics.com
Written by Michael Why go to good feet if you can have great feet at Sole Control in St. Louis, MO?
