Metatarsalgia refers to an inflammatory process along the plantar surface of the forefoot, with pain typically limited to the lesser metatarsal heads.
This condition is commonly found in athletes involved in high-impact activities such as running, jumping or any other sport which increases the pressure applied on the forefoot.
Any kind of excessive or repetitive stress can aggravate the condition; this is why patients are normally advised against wearing ill-fitting shoes or high heels.
The primary cause of Metatarsalgia, however, could stem from biomechanical imbalances brought about by an improper foot posture.
The distribution of load while performing weightbearing activities, depends significantly on foot structure as well as proximal arthokinematic activity.
Compensatory movements associated with an abnormal foot posture, may result in reduced weightbearing capacity of the first metatarsal; hence a major part of the body weight is shifted laterally to the lesser metatarsal heads at toe-off.
The resultant collapse in the transverse arch causes considerable weakening of the forefoot structure, leading to pain and inflammation in the ball of the foot.
Restoring the biomechanical balance of the body becomes a top priority. This entails supporting the arch and correcting the position of the foot by using customised orthotics, which reduce the pressure and friction on the metatarsals.
The functional integration of the foot and ankle becomes an area of prime interest in this regard especially when examining the chain reaction it sets forth during the gait cycle.
The integrated multi-axial postural™ function, caused as a result of this link, leads to constant postural adjustments and readjustments the body undertakes on variable terrains and at variable speeds.
This is at the core of optimal foot biomechanics, necessitating the need to recognise the function of all the articulations in the foot and ankle rather than focusing on a single site of pathology or dysfunction or standard of care.
With much of the load reduced on the site of injury, the orthotics promote healing and the optimal alignment of the joints and muscles in the foot, speeding up the recovery time and preventing recurrences in the future.
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A common paediatric foot condition called Calcaneal apophysitis, or Sever’s disease, has a clinical presentation that includes posterior heel pain on medial and lateral compression with the prevalence of mild swelling in some cases.