All you need to know about metatarsalgia

All you need to know about metatarsalgia

Emma Kirk-Odunubi explains how to recognize, treat and prevent metatarsalgia, the runner’s niggle most of us suffer from every now and then.

Metatarsalgia at a glance

  • Area Affected: Soles of the feet beneath the metatarsals (bones of the foot)
  • Time Off Running: Depends on severity
  • Recovery Time: Depends on specific diagnosis

What is metatarsalgia?

Metatarsalgia is an umbrella term for foot pain. It can be anything related to the sole of the foot specifically around the metatarsals (the bones of the foot). In fact, many foot ailments are treated as metatarsalgia before being investigated thoroughly further.

What causes metatarsalgia?

  • Fat pad thinning/movement: Under our metatarsals, there is a fat pad for protection. As we age, this pad gets thinner and this contributes to increased pressure on the forefoot.
  • high arches: Having high arches can lead to an increase in loading and pressure on the forefoot. This is because the foot shape of a person with high arches often means they put more stress on the calf and Achilles, and this allows less flexion through the ankle joint. Here’s how to choose the right running shoes for your feet.
  • Major weight fluctuations: Changes in weight can cause increased foot pain. Weight gain can come from both lifestyle changes, like a move to a desk-based job, and life changes, such as pregnancy. The latter can also drastically alter your ligament laxity, and that can also contribute to foot pain.
  • Hammer toes: This condition exposes the forefoot to pain as the toes curl up due to tight tendons on the top of the foot. This can create discomfort for the metatarsal heads.
  • Shoes: Poor footwear with a lack of cushioning increases stress on the forefoot. Bear in mind that trainers act quickly if you use them for more than just running. Sports like tennis, netball and boxing require a lot of forefoot movement and this increases stress on the metatarsal heads. Here are the best women’s running shoes.

How can I recover from metatarsalgia?

There’s not one single approach to relieving metatarsalgia but the good thing about that is that, if you suffer from it, there are at least multiple solutions you can try.

Modifying your activity levels is often the first thing to address, and seeing a physio to assess why the pain has been triggered is a good starting point. Beware that the first avenue suggested might be cutting out running to see if the pain improves.

As mentioned, footwear can be a common cause of metatarsalgia so have a think about what you wear during exercise and in your day-today life. Changing what you wear on your feet in the short term is likely to make a huge difference. Think about it: you only spend about 5% of your day in your running trainers, so there’s a lot of other time when damage could be done. Try wearing cushioned support shoes like the Saucony Guide 16 as much as you can; if you wear uniform to work that doesn’t allow trainers, you could get a doctor’s note so you can alleviate the problem and give your feet time to heal.

Insoles are another potential solution, especially for those with high arches. They help with pressure distribution and proprioception, and provide relief to overused areas, particularly the metatarsal heads. Foot pain is debilitating and inconvenient and will likely lead to time off running, so take steps early to find a solution that suits you.

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