Your feet take an awful lot of pressure when you run. They carry your whole body weight, times 2 or 3 when you add gravity to the mix!
It makes sense, then, that ball of foot pain would be a common running injury. It’s also understandable how pain in your foot can really hamper your running performance.
In the medical world, pain in the ball of the foot is known as metatarsalgia. It’s caused by a wide variety of different things, and figuring out the cause of your pain is the first step to getting rid of it.
Keep reading to find out why your pain may be happening, how to treat it, and how to prevent it from happening again once it’s healed.
What is Metatarsalgia?
Metatarsalgia is the medical name for pain in the ball of the foot.
The ball of the foot is the area underneath the foot, right beneath the toes. You see that little fatty pad? That’s the ball of your foot.
As you can imagine, pain in this part of the foot can really ruin things like running and other sports. When you have metatarsalgia, the muscles, tendons, and ligaments surrounding the metatarsal joints (the joints leading to your toes) become inflamed.
There’s a variety of different foot conditions or injuries that can lead to this kind of pain and inflammation. But whatever the cause behind it, pain in the ball of your foot is known by the name metatarsalgia.
Symptoms of Metatarsalgia
Obviously, ball of foot pain is the main symptom! But you may or may not experience a range of other symptoms along with the pain.
So the main symptom is pain. Most often, this is described as a sharp, burning pain in the ball of the foot, although it’s sometimes called “aching” as well. You’ll feel this pain just behind your toes, right in that fatty pad.
It may come with a kind of numbness in your toes, or perhaps a strange tingling feeling. Another common feeling with metatarsalgia is the feeling of having a small stone in your shoe, poking you with every step.
These sensations, along with the pain, can become worse when you’re standing, walking, or even when you flex your feet.
A key symptom of metatarsalgia is that the pain, numbness, and tingly feeling eases up when you sit or lie down and take that pressure off your feet.
What Causes Metatarsalgia?
The causes of metatarsalgia can be extremely varied. Most commonly, though, there’s no single cause. Rather, a bunch of different factors come together to cause this pain. Here are some of those factors.
Intense Training or Activity
It’s no surprise that people who take part in high-impact activities are more at risk for ball of foot pain than those who don’t.
Runners, basketball players, tennis players, and others who play sports that involve jumping or other kinds of pressure on the feet are susceptible to this kind of pain.
This is because the ball of the foot takes a lot of force during pushing off and landing motions. When standing, your feet hold your entire body weight. When jumping and landing, though, that weight can increase by 2 to 3 times as gravity comes into play!
Certain Foot Shapes
If you have high arches or flat feet, you may be at a higher risk of developing metatarsalgia.
This is because the higher or lower arch causes weight to be distributed unevenly across the foot, which may cause more force on the ball of the foot.
This can also happen if your second toe is longer than your big toe. Your bodyweight is shifted in an unusual way to accommodate this, which may cause more pressure on the metatarsals.
Foot Conditions or Deformities
As you’ve just learned, anything that causes your weight to be distributed differently or changes your gait can lead to metatarsalgia. This includes foot conditions or deformities.
For example, having a hammer toe can cause you to alter your gait, putting extra pressure on the metatarsals. The same goes for bunions, swollen feet, and even ingrown toenails!
Carrying excess weight places the feet under extra strain. They have to bear all your weight whenever you stand, walk, or run.
Losing weight can help to reduce pressure on the balls of your feet. Just a few pounds can have a significant effect!
Think about it this way. Let’s assume your feet take on twice your body weight with each hard landing.
If you weigh 150 pounds, when you land hard on your feet, they’re taking on around 300 pounds of force.
Reduce that to 130 pounds, though, and suddenly your feet are only taking on 260 pounds of force. That’s a significant difference.
Poorly Fitting Shoes
This is one of the most common reasons for ball of foot pain. Wearing shoes with a narrow toe box can cause the toes to compress unnaturally, shifting the metatarsals and leading to pain during and after running.
Shoes with insufficient padding, especially in the forefoot, can also increase your chance of feeling ball of foot pain while you’re running.
For the ladies, regularly wearing high-heeled shoes can increase your chances of developing metatarsalgia.
This is because they combine two of the factors that lead to ball of foot pain – a narrow, uncomfortable toe box and a high drop that places pressure on the ball of the foot.
Stress Fractures or Arthritis
Lastly, if you’ve inadvertently fractured a small bone in your foot, it can be the reason behind your pain. It could be a fracture in the actual metatarsal area, or it could be elsewhere but cause ball of foot pain as you shift your weight to get comfortable.
Arthritis can also lead to pain in the ball of the foot, although it’s one of the less common reasons. If you’re predisposed to arthritis or have other symptoms, including pain when your foot is at rest, you may want to get it checked out by a doctor.
How to Ease (or Prevent) Metatarsalgia Pain
Nobody wants to try to push through pain when you’re running. If you find that you’re struggling with ball of foot pain while running, your best bet is to take a bit of a rest and treat your pain using a combination of these methods.
This is the most important thing to do, but it’s also the hardest! The best way to ease the pain of metatarsalgia and bring your foot into a state of healing is to rest it.
Not for an evening between hard runs. Not for a day. For a few days at least, otherwise, it won’t have much effect.
Resting means that you need to be off your feet as much as possible. If you can’t be completely off your feet, you need to at least take a few days’ break from any high-impact activities that could increase your pain.
Rest from sport, wearing the wrong shoes, and just generally putting pressure on the painful area of your foot.
If your foot is swollen, try to elevate it above the level of your heart when you’re relaxing. This will help the excess fluid to drain, lowering the swelling and allowing for better circulation which will accelerate healing.
If you really don’t want to rest completely, at the very least swap out high-impact activities for low-impact ones.
For example, you can switch your running out for swimming or cycling and still get an excellent workout in.
Ice the Affected Area
Applying ice to the sore part of your foot can help to ease the pain and reduce any associated swelling.
Icing a few times a day for 20 minutes at a time can be a big help when used in conjunction with other treatments.
Take an OTC Pain Reliever
If your pain is becoming unbearable, you can use an over-the-counter pain reliever to take the edge off. Try to choose one with anti-inflammatory properties too, like Advil, Motrin IB, Aleve, or aspirin.
Just be careful when taking pain meds. They can make you feel like nothing is wrong, and it can be tempting to go for a run while your foot is feeling great! Don’t be tempted, though – you can end up causing much more serious damage.
Wear Proper Shoes
Making a shoe change can have a big effect on your pain. As mentioned before, avoid wearing high heels as much as possible.
If you need to wear smart shoes for work, try to find some professional-looking flat pumps instead. Your feet will thank you!
Wear shoes with a decently-sized toe box that allows your toes to spread out naturally. There should also be nice cushioning under the ball of the foot. A shoe with a lower heel-to-toe drop can also alleviate pressure on the forefoot, reducing the chance of pain.
Use Metatarsal Pads
If you don’t want to change your shoes, consider trying metatarsal pads. These are little, unobtrusive pads that are either stuck directly to the bottom of your foot or into your shoe.
They offer support and light cushioning right where you need it, in the middle of the ball of the foot. They’re actually designed to distribute pressure evenly, easing the force on the metatarsal bones.
Trying a metatarsal pad is a good idea before you buy insoles or new shoes. This simple little thing could make the biggest difference to your pain!
Consider Arch Supports
For some, a generic insole may provide the support necessary. But for others, specially-made arch supports may be necessary if insoles don’t quite do the job.
Especially for those who develop metatarsalgia due to high arches or flat feet, insoles can help support the foot and reduce pain in the ball of the foot.
But if OTC insoles don’t help, you may need to ask your podiatrist to create a custom orthotic to match your arch and provide the support you need.
Exercises to Help Prevent Metatarsalgia
While taking the measures above will definitely help to reduce metatarsalgia pain and prevent it from happening again, it can’t harm to add these two short but sweet exercises into your schedule.
They’re designed to help strengthen the foot muscles, which can go a long way towards reducing your chance of developing metatarsalgia in the future.
Plantar Sling Strengthener
For this exercise, you’ll need a light resistance band. Anchor it in a loop to something strong like a desk leg, at ankle height.
Place a chair in front of the anchor point, slightly to the left of the resistance band. Sit in the chair and place your right foot into the loop in the resistance band. The band should be situated right in the arch of your foot.
At this point, your leg should be slightly to the right, as the anchor point is to the right of the chair in front of you. Pull the resistance band with your foot until your foot is directly in front of you, as if you were sitting quite normally in the chair.
You should feel a stretch in the band and have to work a little to keep it in that position. Anchor your heel on the ground at this point, with your toes a little off the ground.
Keeping your heel on the floor, swing your foot inwards, pulling the band against the resistance. Rotate your heel on the floor as you do so, basically bringing your foot’s arch closer to your body.
Then, keeping the resistance, rotate your heel back to the starting position slowly. Do as many reps as you can, working your way up to 30 in one session.
Once you’ve done as many as possible on the right foot, reposition your chair or the resistance band so you can do the same with your left foot.
You’ll need a marble and a washcloth for this exercise! Place them both on the floor in front of you and sit in a chair like normal.
Your first exercise is to pick the marble up with your toes, hold it for a 5-count, and then place it back on the floor. Try to do this 3 or 4 times, moving from the big toe all the way to the little toe with your pick-ups.
Then, place the washcloth on the floor and grab the end of it with your toes. Scrunch it up and hold to the count of 5 before releasing it again. 10 to 15 reps on each foot is the magic number!