Pain in the Ball of the Foot = Metatarsalgia

 Pain in the ball of your foot is usually referred to as “Metatarsalgia”. In Latin, the word Metatarsal is used to describe the region of the foot that is equivalent to the palm of your hand. The suffix “algia” simply means pain. So the word Metatarsalgia means “Pain in the Metatarsal region”.

The Anatomy

You have 5 Metatarsal bones which are numbered according to which toes they form joints with. The first metatarsal forms a joint with the 1st toe (big toe), the second Metatarsal forms a joint with the second toe and so on. In Latin toes are called “Phalanges”. In order to understand the conditions that cause pain in the Metatarsal region (Metatarsalgia) a small anatomy and physiology lesson is necessary at this point.
Joints are formed by the connection of bones. Anywhere 2 or more bones connect we have joints. Ligaments connect the bones together at the joints and provide stability to the joint. Without ligaments we would be a blob of tissue. Tendons connect to muscles and cross over joints providing us the ability to move these joints. So muscles and tendons move bones while ligaments provide support and stabilization for the joint. The ligaments most commonly affected in the condition we call Metatarsalgia are called the Collateral ligaments, Plantar Plate Ligaments and the Joint Capsule. Together this collection of ligaments around our Metatarsal-Phalangeal joints essentially hold our toes to our foot. When a ligament is damaged (torn or partially torn) the joint becomes unstable and typically a visible deformity of the joint occurs. This is critical to understand as most cases of Metatarsalgia are misdiagnosed as tendonitis or worse simply as Metatarsalgia……which does not describe WHAT structure is actually injured and causing your pain in the ball of your foot. In the below picture notice the left second toe. It is deviating towards the big toe.

Notice the left second toe. It is deviated/deformed and is deviating towards the big toe.

Notice the left second toe. It is deviated/deformed and is deviating towards the big toe


Notice how the left second toe is deviating towards the left 1st toe. This is because the plantar plate ligament on the outside (lateral side) of the second Metatarsal-Phalangeal joint is partially torn. If left unchecked this ligament will rupture and the second toe will deform even more and cross over the big toe. At that point surgery will most likely be necessary. However if treated at the stage pictured above surgery WILL NOT always be necessary. There is a simple an effective taping technique that can be used to pull the second toe into proper alignment which brings the torn areas of the ligament closer together……which then allows it to reattach and heal.

Ineffective Treatment Strategies
There are many interventions and treatment strategies that we use to fix and correct these damaged ligaments so that you can avoid surgery. Unfortunately for many patients they waste a lot of their valuable time and money consulting ineffective doctors and therapists who either misdiagnose or under-diagnose their condition allowing it to worsen. Some of the more common misdiagnosis are