Metatarsalgia is an obsolete term, it is better to identify what the problem affecting the metatarsal is: it could be bone (hallux valgus and associated deformities), articular (metatarsophalangeal inflammation, extra-articular (bursitis), tendon (inflammation or cyst) tendon, tenosynovitis), nervous (neuromas, nerve entrapment syndromes), overload syndromes (inversion of the anterior planter arch) and finally skin problems (callosity, mycosis) and fascial. Each of these conditions deserves specific treatment and possibly an orthosis and some kind of specific infiltration and / or rehabilitation.

 

Inflammation of the metatarsophalangeal joints is a frequent cause of pain that is often underestimated: the mobilization of the affected toe causes severe pain.

This problem can occur due to trauma or resorption of the plantar fat pad. In this case the infiltration of very little cortisone into the affected joint can have splendid results.

 

Once the factors causing the pain have been identified, action must be taken on the shoe and / or on the insole, if any. The shoes could have a "flat tire" since after prolonged periods of use the sole may have lost its elasticity characteristics, forcing the metatarsal to impact too hard on the ground; the cure obviously consists in the replacement of the shoes. Orthoses should be designed to correct and relieve forefoot pain by means of soft pads. On the market there are excellent and cheap silicone aids.

 

Generally, abstention from sports can last about fifteen days.

Finally we start with therapeutic exercises aimed at improving joint mobility and tendon elongation.

 

EXERCISES FOR METATARSALGIA

This is a simple exercise that allows you to train the intrinsic muscles of the foot, helping to resolve the painful disorders due to metatarsalgia.

 

Stand your feet in front of a wall with your feet about 20 cm apart and your knees slightly flexed. You can support yourself with your hands so as not to lose your balance. The tip of the big toe must touch the wall.

 

It is necessary to bring the head of the first metatarsal (the bone to which the big toe is attached) close to the heel thus removing the tip of the big toe from the wall without flexing the toes (the foot must give the sensation of shortening). This movement must raise the longitudinal arch of the foot.

 

Keeping the "shortened" position of the foot, try to balance yourself on one foot keeping the knees flexed by 10 ° -20 °.

 

Maintain this position for 20 ”keeping the plantar arch as short as possible without other compensatory movements of the extrinsic musculature of the foot.

 

Slowly and without losing balance, release the foot musculature allowing the medial longitudinal arch to lower and return with the foot to the starting position. Repeat 3 times for each foot.