They are a long way away and usually hidden in shoes, but a painful foot will quickly get your attention and stop you doing the things you love. Pain in the ball of the foot is very common in dancers, runners, triathletes, cyclists and people working on their feet all day. Women are more likely to experience forefoot problems than men. Here’s a few examples of problems we look for:
The joints at the base of the toes deal with loads equal to 8 times your bodyweight with every step you take. Once something goes wrong that load can cause serious pain, and often hang around for a long time. There are over 20 conditions that can affect the forefoot joints, and specific problems for different toes, and different stages of life.
The Big Toe:
Sesamoiditis: causes pain underneath the ball of the foot. The sesamoids are a pair of small pebble like bones that sit under the foot. Overuse or trauma can fracture one of these bones and makes pushing off your toes very painful
A more common cause of pain at the base of the big toe is Osteo-Arthritis, leading to stiffness, pain and the development of bunion deformities
The 2nd toe:
can be impacted by stress fractures (runners), Freiberg’s disease (teenagers) or plantar plate tears (cartilage and ligament damage).
Morton’s neuroma happens in the space between the 3rd and 4th toe bones. It’s common in female runners and cyclists. Scar tissue forms around a nerve leading to burning pain and numbness in the ball of the foot.
It’s important to be assessed properly, but for all forefoot problems there are some Foot First Aid principles that may help
- Avoid walking in bare feet, especially on hard floors
- Try a stiff-soled shoe which limits bending at the ball of the foot (trail runners instead of road running shoes for example)
- Avoid high heels and shoes with a narrow toe box
- Adjust your cycling shoes by moving the cleats to reduce pressure on the forefoot
- Look at the way you sit at work, many of us pull our feet back under the chair with our toes bent right back
If you’ve been putting up with sore feet, don’t ignore them. We can help to cut through all that complexity, find out what’s causing your pain and come up with a specific plan to get you back on your feet and keep you there.