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Q&A: How to Treat Pain in the Ball of Your Foot

I have some pain in the metatarsal area (ball of foot) on my right foot. I just ordered metatarsal pads, but is there anything else I can do?

Metatarsalgia is commonly described as pain in the ball of the foot and is an overuse injury. The foot is made up of many bones, and the long bones of the foot are called the metatarsals.

The point at which the metatarsals join the toes is the ball of the foot, and this where metatarsalgia is felt. It can be a sharp, dull, or burning pain which worsens with activity—such as running and jumping—as well as with weight bearing through the ball of the foot. Some people have also described feeling as though there is a pebble in their shoe. Runners often feel metatarsalgia because during running, weight is transferred from the back and midfoot to the forefoot for push-off.

There are several causes of metatarsalgia, which include:

  • An increase in training or activity
  • A foot with a higher arch or flatter arch, which alters normal foot mechanics and can cause increased weight bearing in the ball of the foot
  • Wearing poor fitting shoes or high heels
  • Increased BMI
  • Stress fractures
  • Morton’s neuroma*

*While Morton’s neuroma is not exactly metatarsalgia, it is an irritation of the nerves between the second and third metatarsal bones.

Treatment for metatarsalgia includes rest, ice, and use of NSAIDs, as well as changing and avoiding pain-inducing activities; these activities would include jumping and running, and wearing tight shoes or high heels. Stretching the calf is often helpful, as is making sure that you are wearing proper running shoes with adequate cushioning.

Metatarsal pads are also helpful, in that they provide cushioning and can offset the weight distribution of the foot. Over-the-counter and custom orthotics may be helpful in improving weight distribution during activity, too.

Wearing the proper running shoes is also important since you want to make sure that you are distributing force across the foot appropriately. If possible, runners should have their running form assessed, in order to determine if their running form is contributing to altered force distribution through the kinetic chain.


Julie Khan

Julie Khan is a physical therapist with HSS Rehabilitation. She graduated from Columbia University with a masters and doctorate in physical therapy and has her Board Certification in Sports Physical Therapy. Her clinical interests include post-surgical sports-related injuries and running mechanics. An avid runner herself, Julie enjoys rehabilitating runners and helping them get back to their sports safely and even stronger than before. She is a USATF Level 1 Coach as well as a Road Runners Club of America certified coach. She has completed more than 20 half-marathons and eight marathons.

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