The forefoot is made up of more than half of the bones in the foot which is why forefoot pain affects a lot of people. Our feet are dynamic structures and forefoot pain can be from a number of causes such as Morton’s Neuroma, Sesamoiditis, Capsulitis, Hammer Toes, Claw Toes and Metatarsal Stress Fractures.
Morton’s Neuroma
Morton’s Neuroma can cause a burning pain or sharp pain in the toes. There are nerves in the foot which run in-between the long bones in the foot. It is where there is a knotting or a bud of atypical nerve tissue which can get irritated and cause acute forefoot pain. When a podiatrist examines the forefoot pain, it is not uncommon that we cannot reproduce the pain as the nature of the forefoot pain caused by a Morton’s neuroma typically “comes and goes”. It can be aggravated by wearing shoes that are too narrow in the forefoot.
Sesamoiditis
Sesamoiditis is inflammation of the marble like small bones that sit under the ball of the foot near our big toe. Your may have sesamoiditis if you find it painful to hop on one foot or go up onto your tippy toes. It is a common injury for someone who may wear high heels a lot. Inspire Podiatrists see this injury in a lot of dancers who place increase loads on their forefoot. These small bones have an important function to help act as ball bearings for the long tendons that run along our arch to the ball of the forefoot. The sesamoid bones help the tendons to slide as we propel off our foot during running and walking. If sesamoiditis is left untreated this inflammation causes pain in the forefoot which can then lead to stress fractures of the sesamoid bones.
Capsulitis
Capsulitis or inflammation of the metatarsophalangeal joints in the foot can cause a lot of forefoot pain. It is common to see capsulitis in a patient who may have a bunion. Another cause of capsulitis can be from a patient who has osteoarthritis in the foot such as hammer toes or claw toes. This increases the pressure load on the joints, causing forefoot pain on the heads of the metatarsals which are taking the load under your forefoot when you toe off during walking.
Hammertoe/ Claw Toes
This is where your toes bend into a funning shape and cause pain in the digits of the feet as part of forefoot pain. The process of the formation of hammer toes or claw toes does not happen immediately. It is a process which is gradual caused by muscle imbalances in the foot which allow soft tissue changes which cause forefoot deformities and forefoot pain. Hammer toe or Claw toes are a type of osteoarthritis in the feet as the joints of the phalanges (toes) bend out of shape which can cause rubbing on the tops or sides of the toes in footwear.
Stress Fractures
Stress Fractures are one of the more serious injuries which cause forefoot pain. Otherwise known as march fractures, they often occur in the metatarsal bones of the forefoot. The long bones in the foot are more prone to stress fractures as they act as lever arms in the foot to help propel and push the foot forward during running and walking. Inspire podiatrist commonly see this in long distance runners. It is important to tailor your training program to ensure the bone stress on the metatarsals is not too high to avoid getting a stress fracture. Custom soft prescription orthotics can be used to reduce the occurrence of stress fractures in the forefoot as well as correcting muscle imbalances with strengthening exercises.
Inspire Podiatrists are committed to offering the best recovery management plan to address your forefoot pain. As running techniques experts, we are passionate about sports podiatry and want to correct the muscle imbalances that may be contributing to your forefoot pain. Located in Albany Creek, we are the Brisbane Northside sports podiatrist of choice. We offer a range of hands on treatment methods, above and beyond just orthotics. Whilst we will provide 3D laser scanning to make soft prescription orthotics where needed, we utilise many other hands on treatment modalities. These include:
- Shockwave Therapy
- Western medicine acupuncture (dry needling)
- Muscle energy techniques
- Foot mobilisation
- Electrotherapy (TENs & Ultrasound)
- Gait retraining and running technique assessments
- Balance and strengthening exercises.