Do I Need to See a Biomechanical Podiatrist? - Episode 4

Biomechanical podiatrist Michael Thompson is back with the fourth and final episode of his series on foot pain.

Episode 4: Waging War on Foot Pain – Metatarsalgia

Metatarsalgia foot pain

Watching the Oscars this week made me wince. No, it wasn't because of the make-over they gave Robert De Niro to make him look younger in The Irishman, it was those high-heels worn by the actresses. As a podiatrist I cannot help but worry about the punishment those poor feet are going through. Shoes that are tight around the toes with elevated heels, can lead to soreness in the ball of the foot and may develop into the painful condition known as Metatarsalgia.

Metatarsalgia plantar view

Metatarsalgia is an umbrella term for pain in the metatarsals. As a sports podiatrist I don't see many actresses but I do see plenty of runners, cyclists and climbers with this condition. Their pain is definitely not from wearing high heels but it might also be caused by excessive plantar pressure in the forefoot region.

Tightness in the calf, hamstring and plantar fascia which changes the way you walk can also lead to Metatarsalgia. And I also see patients who have lost the arch that goes across the foot (transverse) causing more pressure in the area in the picture above.

The big question is: 'how do I treat Metatarsalgia'? My top tips would include:

  • Getting flexible in your calf, hamstring and plantar fascia. Try Paul Hobrough's 'pre-hab' stretch routines or get his Runner's Expert Guide to Stretching;
  • Get strong in your foot and calf with a tailored exercise programme: you may find this video from Healthy Step useful;
  • Wear supportive footwear as much as possible;
  • Offload the area with an orthotic to reduce stress on front of your foot;
  • If the pain persists, go see a podiatrist.

Oh and one final thing... take off those high heels!

About Michael: 

Michael graduated in 2001 with an honours degree in Podiatry from Glasgow Caledonian University. Starting his career in York he developed a great interest in the biomechanical aspect of podiatry. Moving to Australia for 18 months allowed further education and development of his biomechanical skills. For the last 11 years he has worked as the lead biomechanical podiatrist in North Somerset with the Musculoskeletal Service. 

Please do get in touch with Michael via or contact him at Bristol Physio. 

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