Forefoot Pain or Ball of Foot Pain

Do you suffer from forefoot pain or ball of foot pain?

Forefoot pain is a common complaint, one experienced by many of the general and sporting population. It is the umbrella term used to describe a variety of conditions affecting the ball of the foot. As it refers to a multitude of injuries symptoms may be slightly different for each particular underlying cause. Some general forefoot symptoms can include pain in the ball of the foot, numbness, pins and needles or burning sensations.

What is forefoot pain?

Forefoot pain encompasses a variety of conditions and can be associated with acute trauma or overuse. Some of the common causes can include:

  • Inflammation of the metatarsal joints (ball of the foot) – this is usually associated with a “too much, too soon” principle when increasing your activity or training too quick for the body to handle.
  • Stress fractures – are small cracks within the bone and are caused by repetitive loading over time. People are often unable to recall the exact time of the initial injury, unlike acute fractures where you can pin point the time of the injury. Stress fractures are also associated with “too much, too soon”.
  • Fat Pad Atrophy – as we age, the fat pad that sits underneath the ball of our foot and provides cushioning can thin out over time. We depend on this fat pad to provide shock absorption and to evenly distribute force through our feet as we walk. When this fat pad becomes thin or atrophied it can lead to pain from a lack of cushioning, meaning more force goes through our bones as we contact the ground.
  • Morton’s Neuroma – usually seen in women between 40 and 50 years of age. It is considered damage and irritation to the nerve that runs in between your 3rd and 4th metatarsals (long bones of the foot). Symptoms can be numbness, tingling and pain in that area. It is thought that over pronation and tight fitting shoes can contribute to the development of this condition.

What causes it?

Most forefoot injuries are cause by the “too much too soon” principle or the mechanical pattern of your walking and running cycle. Excessive pronation (rolling in) or excessive supination (rolling out) can lead to uneven stress throughout the feet causing increased pressure in particular areas. This increased pressure may be too much for the body to handle and pain usually indicates damage is occurring as a consequence, this can be damage to the bones, ligaments, muscles, tendons or nerves.

What does it feel like?

The symptoms can vary due to the underlying cause. Your podiatrist will be able to take a thorough history of your symptoms to assist with the diagnosis of your condition. Overall symptoms can include pain, burning, cramping, numbness, pins and needles, sharp pain, stabbing pain, dull ache, bruised sensation etc.

What can you do to manage it?

Treatment relies on accurate diagnosis. This means the sooner you are diagnosed by your podiatrist the quicker a tailored management plan can be put into place to return you to your daily activities and goals. You may try some of the following initial management strategies including rest, ice, stretching, offloading and adequate footwear until you can be seen by a professional.

What should you avoid doing?

Avoidance of aggravating factors is necessary to allow your body a chance to heal. Therefore; if running or jumping causes the pain then look to other activities such as cycling or swimming. Your podiatrist will be able to guide you to other activities that will minimize stress and impact on the affected structures and offer you a good chance to begin the healing process.

Management:

Your podiatrist will provide an assessment that will look at your symptoms, foot posture, gait and footwear. They will then be able to provide you with a custom-made management plan that is targeted to your foot and current injury. This may include icing, massage, stretching, strapping, footwear, padding and if necessary orthotics or insoles.