Metatarsalgia

Metatarsalgia is a condition we frequently see at the San Diego Running Institute. This painful foot condition is often misdiagnosed or confused with plantar fasciitis or Mortons Neuroma. A runner will complain of pain in the ball of their foot usually just behind the second or third toe. The pain can be intense or just a dull ache that they describe as “walking on a rock’ or “walking right on the bone”. The pain can be intense enough to cause you to stop running.

Often, these runners have been to a foot doctor or sports doctor who made them custom sports orthotics with a metatarsal pad. When I ask the runner if it helps they will typically reply “no” and that “it does not help at all and may be making it worse”. The problem is that the metatarsal pad has been placed incorrectly on the custom orthotic. It is essential to have the metatarsal pad in the correct location in order to ease the condition. Essentially the ligament that helps support and stabilize the 2-4th metatarsal bones and metatarsal arch is sprained. This causes laxity in the ligament which allow the metatarsal bones to “drop” and be lower to the ground. When the metatarsal pad is placed correctly just behind the metatarsal head (just behind the painful location) alleviation of the foot and arch pain is achieved. It is not unusual for me to correctly place a metatarsal pad for a patient and have them walk pain free right then and there! There are many different metatarsal pads available but I have found the Pro-Tech Metatarsal pad to be the easiest, most convenient and effective metatarsal pads to use. While this is a fast and effective treatment for metatarsalgia it is sometimes not enough to fix this common running foot injury. When this “quick-fix” fails the San Diego Running Institute can refer you to Dr. Victor Runco. He is a foot pain specialist and has helped hundreds of runners and non-runners with metatarsalgia and other foot pain conditions.

If you have pain in the ball of your foot or have been diagnosed with plantar fasciitis, Mortons Neuroma or metatarsalgia and have not been helped stop by the San Diego Running Institute and talk to one of our running specialists or if you prefer call and schedule an appointment with Dr. Runco by calling 619-265-2222.

Below are step-by-step instructions to place metatarsal pads.

Before we get started, you need to purchase metatarsal pads. Once you have them do the following:

1) Take your insole out of your shoe and place it on the floor in front of you.

2) While sitting, take a jar of liquid and place some with the applicator on the spot on your foot that is painful when you walk/run.

3) Carefully place your foot on the insole and stand up while exerting a little pressure on the ball of your foot.

4) Sit back down and remove your foot. You will see the white mark on the insole which is now representative of where your pain is.

5) Remove 1/2 the backing on the metatarsal pad and stick it so that it is just behind your white mark.

6) Put the insole back in the shoe and walk/run for a bit.

7) You will “feel” where to move it there. You may have to move it millimeters to the right, left, front, or back to get the perfect spot but when you do, it should alleviate your pain/symptoms 50% – 100% (The pad is not supposed to be beneth your pain. It is not a cushion for your painful area. It needs to be just behind where your pain is which, is why the placement is so critical. Many a patient I have placed pads for and they havetold me they tried them before and they did not work… they work, they were just placed wrong.

8) After getting it in the perfect spot, take a Sharpie marker and trace the pad so the placement you will always know. Now remove the pad and take off the rest of the padding and stick it back down to the insole.

9) Cover with Duct tape to prevent pad from coming off.