The Center for Podiatric Care and Sports Medicine

That’s Very Metatarsalgia

Posted by on Thursday, May 3rd, 2012


Once upon a time there was a girl who liked to run. She felt that regular running in the parks wasn’t challenging enough, though; it was too easy to get lazy, especially since she was not a born speedster. Then she discovered a giant flight of stairs leading to a high point in her local park. She got the idea that running up and down those stairs would be a much better workout than just running. And she was right! Running up and down the steps was hard. The people who used the steps to walk in and out of the park thought she was crazy, but they got used to her. The girl kept running up and down the steps, thinking, “This is great! I bet I will be really fast on a straight, flat path now!”

Then one day the balls of her feet started to hurt. She thought it was because her shoes were worn out. She got new shoes, but that didn’t help. The pain got worse and worse, so bad that when she was home during the day she walked awkwardly with her toes pointed up to take pressure off her forefoot. She began to ice her feet, but that only helped for a little while. At night her feet ached. Finally she admitted that running up the steps, which generally meant bouncing on the balls of her feet, was destroying her feet. She found a steep hill near those stairs and has been running up that since. The people who use the hill to go in and out of the park think she is crazy, but they are getting used to her. More importantly, her feet are starting to feel better.

Who was that idiot running up and down those steps, slowly beating her feet into a painful mess? Why, that idiot was me! Of course.

The reason I tell this story is because it relates to today’s topic: metatarsalgia. Because that’s what I think I have/had. So let’s talk about metatarsalgia!

What on earth is metatarsalgia? As you no doubt recall from either high school anatomy or dedicated reading of this blog, the metatarsals are the long foot bones that connect to your toes. The metatarsal heads are located in what we call the ball of the foot or forefoot, the area between the arch and the bases of the toes. Metatarsalgia, then, is a general term for pain in the ball of the foot. Like the kind you get from bouncing up and down concrete steps for an hour at a time, day after day.

What are the symptoms? Yeah, I mean, I get it, pain in the forefoot, but how do I know it’s more than just a day of tired feet? Easy answers on both points–yes, it is pain in the forefoot, and yes, it may be more than just a tough day on your feet if you find the pain lingering for more than a day or two. Also start to pay attention if the pain is more sharp or burning than just achey, and if you feel any numbness or tingling in the ball of your foot.

What causes metatarsalgia? Other than running up and down concrete steps daily? Thank you again for reminding me that I’m an idiot! Metatarsalgia is caused by anything that puts undue pressure on your forefoot, such as wearing stilettos, high impact sports (think basketball, gymnastics), obesity, or biomechanical problems. Painful conditions such as bunions and hammertoes can also cause people to begin to walk in awkward ways that then lead to metatarsalgia. Runners who try to switch too quickly to minimalist running shoes from standard running shoes can also develop metatarsalgia. Some people are just prone to metatarsalgia because of their foot shape; high arches, and a long second toe can make metatarsalgia more likely to occur (congratulations to me! I have both).

What do I do about metatarsalgia? What is the treatment? The first step is to stop doing whatever is causing the problem. Start running on softer ground, take the heels down a few inches, make sure you’re wearing shock absorbing shoes for basketball. Ice can relieve pain temporarily (as I found) as can just a few days of general rest for your feet, or as much rest as you can give them.

If, however, you can’t stop doing whatever is causing the metatarsalgia, or you find that it keeps returning, you should see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) to diagnose the root cause of the problem and solve that. A podiatrist can do a thorough examination and make sure there aren’t additional problems like stress fractures or a Morton’s neuroma. The podiatrist can then try to address your metatarsalgia through other methods, such as custom orthotics that will help take pressure off the painful areas. The podiatrist can also analyze your walking and running style to find out if you have a biomechanical issue that is causing undue pressure on your forefoot; this, too, can often be solved with orthotics or adjustments in your gait. Sometimes stretching and physical therapy can help; others believe that massage or ultrasound therapy can offer relief.

There, everything you ever wanted to know about metatarsalgia, or I hope everything! If you think you have metatarsalgia or any other foot problem, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.