Ball of Foot Pain I (Metatarsalgia)

Definition:
Pain in the plantar forefoot metatarsal area.

Symptoms:
This condition usually causes a burning sensation in the plantar forefoot region and can become very painful. Sometimes patients may describe the pain as a lump underneath the ball of the foot. Applying pressure to the plantar surface of the metatarsal heads may elicit pain.

Biomechanical etiology:
When a foot is pronated excessively for any length of time, there is a progressive weakening of the soft tissue structures, resulting in ligamentous laxity and muscular wastage. In the forefoot, as this occurs the metatarsals plantarflex and rotate. This results in shearing forces on these foot structures, which causes pressure and pain. After a period of time the foot may experience nerve damage or callosities.

Treatment:
VASYLI orthotics re-align the metatarsal heads by dorsiflexing the 2nd, 3rd & 4th metatarsals to their neutral position, using a in-built metatarsal raise to correctly position the metatarsal bone and maintain this position. By controlling excess pronation orthotics also prevent plantar-flexion and shearing of the metatarsal shafts. By balancing the weight distribution over the five (5) metatarsal bones, this helps remove excess weight & friction, which commonly causes the callous and burning sensation.

Exercises:
� Intrinsic forefoot exercises

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Ball of Foot Pain II (Morton's Neuroma)


Definition:
Commonly associated with Metatarsalgia (see previous condition), Morton�s Neuroma is commonly an entrapment of the interdigital nerve lying between the third and fourth metatarsal bones.

Symptoms:
Morton�s Neuroma exhibits similar symptoms to Metatarsalgia, but may also cause numbness, tingling and discoloration of the third and fourth (lesser) toes.

Biomechanical etiology:
Please refer to aetiology of Metatarsalgia. Tight fitting ladies�shoes tend to aggravate this condition because they squeeze the metatarsals together,
pinching the nerve.

Treatment:
Orthotic treatment may greatly assist in the early stages of Morton�s Neuroma when damage to the nerve sheath is minimal. Orthotics re-align the metatarsal shafts, re-distribute the weight on the foot and prevent interdigital nerve impingement. Severe fibrosis of the interdigital nerve may require surgery. However, the use of orthotic devices may prevent further problems post-operatively.

Additional treatment: Ice therapy. Wear wider shoes to allow the metatarsals to spread

Exercises:
Intrinsic forefoot exercises