Wednesday, March 27, 2013

3 Common Injuries at the Ball of the Foot

The ball of the foot is the soft pad just behind your toes that forms the forward base of the arch. Generally speaking, the ball consists of fatty tissue protecting the metatarsal bones, five long bones connecting the phalanges (toe bones) to the rest of the foot. Because, along with the heel, the ball absorbs the vast majority of the pressure and stress during normal walking and running, it is also prone to injury.

Here, we describe three common sources of ball-of-foot pain which may require some form of treatment.

Metatarsalgia – Metatarsalgia is the given name for the nondescript, potentially throbbing pain sometimes felt in the ball of the foot. It may also sometimes be called a stone bruise (due to the potential for it emerging following blunt trauma to the region by stepping on a small sharp rock). It is the functional equivalent of a toothache in the ball, and comes as a result of undue stress or trauma placed on one or more metatarsals. With metatarsalgia, the ball is typically very tender to the touch, making it difficult to walk, and it is sometimes accompanied by swelling. The condition typically arises as a result of a combination of natural propensity for the injury (from structural problems in the foot) and overuse, such as by extended running, walking, or standing. Resting and icing the injured area can help speed the recovery process and give your ball of foot relief.

Morton’s Neuroma – A neuroma is a tumorous growth of nerve tissue, but in this case, it is a misnomer. In actuality, Morton’s neuroma is typically a buildup of fibrous tissue surrounding a nerve running along the metatarsals, rather than growth of the nerve itself. Morton’s neuroma is benign, but it may result in pain or numbness in the ball of the foot, especially when ill-fitting or old shoes are worn. It typically occurs due to the rubbing of metatarsal bones against the nerve, which may be made more severe by shoes that are too tight or awkwardly fitting. Shoes specially designed for orthotic comfort may reduce the pressure placed on the nerve and provide a much-needed comfort to ball of foot pain.

Sesamoiditis – This is an injury to the bones directly behind the large toe, called sesamoid bones. It typically results in pain and swelling to the inner ball of the foot (so the right side of the ball on the left foot, and vice versa on the right). It may occur due to excessive bending of the large toe in an unusual direction, or by shoes that put a lot of stress on that particular area of the foot (especially high heeled shoes). Reducing stress on the foot by using orthotic insoles may help in reducing pain during recovery.