Causes and treatments of Metatarsalgia

It is one of the most frequent injuries in runners. 

Our collaborator Healthing tells us on this occasion how to detect, treat and prevent this very common injury among runners. 

Each of our feet is composed of 5 metatarsals that are the 5 long bones that extend along our plantar arch. And "algia" means pain, therefore we translate it as pain in the metatarsals.

It is one of the most frequent injuries in runners. 

How do I know that I have metatarsalgia?

This pathology can be identified because it is a local pain just below the toes that appears mostly with support (when we walk or run) and usually disappear with rest.

In addition, sometimes in areas with excess pressure may appear hardness in the plantar area type callosities (hyperkeratosis) or nails (helomas). Even in the insoles of the shoes you can see marked points of higher metatarsal and / or digital pressure.

It is very typical also to have the toes in claw and restriction in the flexion of the fingers. 

What can it be due to?

During the race, the anterior part of the foot absorbs the entire impact of the stride. If the loads are not well distributed, an increase of support in the head of the metatarsals can cause inflammation and irritation. This can occur due to the following factors:

  • Un static imbalance of foot type dig (a lot of plantar arch): prevents the correct distribution of loads in the foot, mainly by loading the weight of our body in the front.
  • An extensor hypertonia joint of the toes that fixes the metatarsophalangeal joint in extension.
  • An bad career technique with excessive support in the forefoot.
  • Shortening of the posterior musculature of the legSoleo and twins cause an excess of support in the anterior part of the foot.
  • Inadequate footwear with little cushioning and stability or with excess mileage.
  • Bunion: causes a misalignment of the anterior part of the foot, specifically the first finger.
  • Overweight.
  •  At other times the metatarsalgia may be due rheumatic diseases (arthritis, arthrosis) or metabolic (diabetes, gout).

How can we solve it?

The best way to approach the problem is to know its cause. Therefore the most advisable thing besides rule out rheumatic and metabolic diseasess is to make a tread study with a podiatrist, this will be the one that considers if they are necessary some custom templates that eliminate the points of maximum pressure.

It will also be necessary treat the injury with physiotherapy to reduce pain, inflammation and eliminate any type of joint hypomobility that can alter the distribution of loads (fixation in bones such as scaphoid, cuboid, wedge ...), this we will achieve with manual therapy, osteopathy, invasive therapy, Indiba, laser y other techniques

How can we prevent it from reproducing?

To prevent the injury from reproducing or maintaining itself in time or even to prevent it, it is advisable to work with a trainer on the running technique, make the corresponding breaks between workouts and insist on stretching the posterior leg chain to avoid muscle shortening. .

If the lesion persists or there are suspicions of other types of injuries such as stress fracture, Morton's neuroma, etc. it will be advisable to do imaging tests such as ultrasound or radiography. 

In our Healthing medical center you can find all the professionals that can help you to treat this pathology.



Healthing, Calle Serrano, 61. 4th floor - 28006 (Madrid)

Telephone: + 34 91 426 29 24

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