Anyone successfully dealt with metatarsalgia/forefoot pain?

[Eship]

I have been dealing with pain along my metatarsals/forefoot for about two months now and it doesn’t seem to be improving. It’s not serious, maybe a 3/10, but is constant when standing and walking.
It came up after a short and easy ruck in March (3 miles, 60lbs), but has persisted likely due to that fact that I am on my feet all day at work. While I am usually a runner, I had not been running for a few months leading up to this occurring, but I’d like to return to my typical schedule of running when the days get longer and weather gets warmer.
To address it, I have bought new shoes (flux adapt runners) which I wear at work. They are the same shoes I wore previously, just the old ones were worn out. They have a wide toe box and zero drop heel which I am used to.

For anyone who has had a similar issue, I’m interested in what helped you. I’ve had plantar fasciitis before and what helped that was cessation of running and a massive amount of calf stretching. It still took 6 months for it to go away and like 9 months before I got back to running.

 

[Sawbonehunter]

Still sole shoes will be best, not to allow for bending in toes


Sent from my iPhone using Tapatalk

 

[JohnB]

I bought a Beastie Ball to roll my foot with. Start with the softer version then upgrade to the green firm version. Occasionally it still comes back for a few days but getting back to rolling takes care of it. A golf ball may work but the knobs of the Beastie Ball sure get the spots for me.

 

[Predator_SD]

#1 Threw my Crispi boots in the trash, every pair.

Once that was done here is what i did. Totally went away from overly stiff, overly supportive shoes/boots and totally reversed course to super soft/super plush. Started wearing Hoka Bondies with an extra thick overly cushioned Powerstep insole. Also temporarily switched to some Hoka Boots but with high cushion. Also wore Hoka recovery slides in the house with socks as the foam i found can leave your soles feeling a burning sensation. So basically i was walking in poofy cushioned clouds for about 7 months. Stayed off my feet when not necessary.

As to exercise i walked and walked and walked on those soft cushioned shoes and boots. 7 months of that and i was on the mend big time. Not perfect but 80% better. Now i’m to the point of moving back to more normal shoes but still watching the heel drop, you want low. Also looking for a softer, more flexible type boot for hunting.

Long term, i’ll never wear a stiff, hard soled European boot again of any name brand.

Best of luck, Metatarsalgia is no joke it can make life miserable!

 

[cacklercrazy]

My problem was so bad I end up having surgery. I had a basically digit bone pushing out the pad. Felt like I was walking around on a rock. The surgery helped, but still deal with pain in the pad. My Dr said I have not much cushion left in my pad. I hate to agree with the negative things about crispi boots, but any boot with a steep drop is death. The powerstep soles have been good. I went back to my old Irish setter hikers. You can also try adding pads to your inner soles . Good luck

 

[Eship]

I bought a Beastie Ball to roll my foot with. Start with the softer version then upgrade to the green firm version. Occasionally it still comes back for a few days but getting back to rolling takes care of it. A golf ball may work but the knobs of the Beastie Ball sure get the spots for me.

I have one of those lying around so I’ll give that a try. Previously when I had plantar fasciitis, I found rolling to not be effective, but I’m still open to trying it. Was likely due to starting off with something too firm too soon.

 

[Eship]

#1 Threw my Crispi boots in the trash, every pair.

Once that was done here is what i did. Totally went away from overly stiff, overly supportive shoes/boots and totally reversed course to super soft/super plush. Started wearing Hoka Bondies with an extra thick overly cushioned Powerstep insole. Also temporarily switched to some Hoka Boots but with high cushion. Also wore Hoka recovery slides in the house with socks as the foam i found can leave your soles feeling a burning sensation. So basically i was walking in poofy cushioned clouds for about 7 months. Stayed off my feet when not necessary.

As to exercise i walked and walked and walked on those soft cushioned shoes and boots. 7 months of that and i was on the mend big time. Not perfect but 80% better. Now i’m to the point of moving back to more normal shoes but still watching the heel drop, you want low. Also looking for a softer, more flexible type boot for hunting.

Long term, i’ll never wear a stiff, hard soled European boot again of any name brand.

Best of luck, Metatarsalgia is no joke it can make life miserable!

I have started on that path already. I bought new shoes, added a soft insole, put an insole in slippers that I now where around the house, and I make a concerted effort to always have something cushion on my feet unless I’m walking in soft grass. Previously, I rarely wore anything if I was in my house, but I have hardwood floors so that wasn’t helping. 7 months for recovery actually makes me more hopeful since that is in line with what it took for my plantar fasciitis to heal up, and it tells me I just need to continue what I’m doing and be patient. I’ve worn zero drop shoes for daily wear and running for a few a years now, but my boots still have a heel that I’ll be looking to move away from.

 

[Eship]

My problem was so bad I end up having surgery. I had a basically digit bone pushing out the pad. Felt like I was walking around on a rock. The surgery helped, but still deal with pain in the pad. My Dr said I have not much cushion left in my pad. I hate to agree with the negative things about crispi boots, but any boot with a steep drop is death. The powerstep soles have been good. I went back to my old Irish setter hikers. You can also try adding pads to your inner soles . Good luck

Sounds miserable. Glad you’ve found ways to manage it. I’ll check out the powerstep insoles

 

[Predator_SD]

Sounds miserable. Glad you’ve found ways to manage it. I’ll check out the powerstep insoles

There are all kinds of Powerstep insoles and i don’t wear these ones regularly when my feet aren’t injured but these are the ones that worked the best for me when my metatarsalgia was at its worst. They are really soft, thick, and spongy. Not sure how good they’d be long term as they take a lot of volume up in your shoe so i had to really loosen the laces. But they were great when even walking around Home Depot for 20 minutes was misery in regular shoes/insoles. Made everyday things tolerable as we all know staying off our feet is pretty much impossible.

Best of luck

 

[Eship]

Thanks for all the suggestions

 

[cacklercrazy]

Sounds miserable. Glad you’ve found ways to manage it. I’ll check out the powerstep insoles

Believe i deal with a lot of foot pain. I'm on my feet all day. May times in rubber boots which are hell on your feet.

 

[Eship]

Believe i deal with a lot of foot pain. I'm on my feet all day. May times in rubber boots which are hell on your feet.

Yup, I hunted most of last season in rubber boots because I do a lot of river crossings, and I think they contributed significantly to developing the pain

 

[Air Bear]

I developed what i thought was metatarsalgia but later found it to move between sesamoiditis and plantar fasciitis. Same ligament I think, just different ends of it (heel vs toe). Im 7 months in and have been diligent about multiple different treatments. R.I.C.E., nsaids, massage ( not fun massage) and finally this week gave in to a cortisone injection. Doc said stick with stiff boots and solid insoles, but you all have me wondering if i should be going the other direction.

Im losing hope and with draw results coming out im really starting to wonder how i will approach this season.

Anyway, i really didn’t contribute anything to this thread, but glad I found it. Look forward to more successful recovery stories here. Please keep updated on your progress.

 

[Eship]

I developed what i thought was metatarsalgia but later found it to move between sesamoiditis and plantar fasciitis. Same ligament I think, just different ends of it (heel vs toe). Im 7 months in and have been diligent about multiple different treatments. R.I.C.E., nsaids, massage ( not fun massage) and finally this week gave in to a cortisone injection. Doc said stick with stiff boots and solid insoles, but you all have me wondering if i should be going the other direction.

Im losing hope and with draw results coming out im really starting to wonder how i will approach this season.

Anyway, i really didn’t contribute anything to this thread, but glad I found it. Look forward to more successful recovery stories here. Please keep updated on your progress.

I know I’m the one asking for advice on here, but I should add that I have worked in physical therapy and I am an OTA, and have spent a lot of time managing injuries myself and helping out others. With the current evidence out there, I highly recommend AGAINST the RICE method and NSAIDs. I also would avoid the cortisone injection unless you were physically unable to walk or do your job. Cortisone injections really only are helpful for 6-12 months an can cause joint damage, so they’re counterproductive in a way. As far as RICE: Rest is beneficial in that you should avoid things that cause significant pain, but you should pursue exercise that will maintain or increase strength in the surrounding tissues because if you rest them completely, they will just get weaker and more prone to injury. Also, exercise promotes blood flow to the area which will promote healing. Ice is beneficial only during the acute phase of injury for reducing pain, but there are quite a few studies showing it to be harmful to recovery. I would NEVER use ice on a chronic injury, or beyond the first 72 hours for an acute injury. Ice reduces blood flow which is necessary for recovery. I would advise heat application 97% of the time over ice as it increases blood flow, which is essential for an area like tendons/ligaments in the foot which get very little blood flow to start. The whole concept from compression comes from the practice we use for treating swelling. Everything will say to use compression to reduce swelling, but most of the time, there isn’t any real swelling to speak of unless it’s like a major sprain or fracture and in the acute phase, so you should not be wrapping once an injury is chronic (persisting for weeks and beyond). Elevation is the same thing, your chronic injury is not swollen most likely, elevation is useless in this case. Also, it’s debatable as to whether you want to treat each of the symptoms associated with the acute phase of injury such as inflammation and swelling because these are your bodies natural defenses to protect the injured site while it prepares to heal the area. I’d recommend just avoiding activity that gives you more than a 4/10 pain, applying heat daily, and then maintaining all exercise that causes NO pain. So if you can ride a bike, walk in grass, etc. without pain, do that.

That last part of not interfering with the natural process is also why I recommend against NSAIDs. If the pain is that bothersome, I’d recommend using a pain reliever other than an NSAID such as acetaminophen.

 

[Eship]

I developed what i thought was metatarsalgia but later found it to move between sesamoiditis and plantar fasciitis. Same ligament I think, just different ends of it (heel vs toe). Im 7 months in and have been diligent about multiple different treatments. R.I.C.E., nsaids, massage ( not fun massage) and finally this week gave in to a cortisone injection. Doc said stick with stiff boots and solid insoles, but you all have me wondering if i should be going the other direction.

Im losing hope and with draw results coming out im really starting to wonder how i will approach this season.

Anyway, i really didn’t contribute anything to this thread, but glad I found it. Look forward to more successful recovery stories here. Please keep updated on your progress.

also, I know massages aren’t supposed to be fun, but if the massage you’re doing irritates it, I would stop that too. Tendons and ligaments get stronger through load, not through massage.

Also, one more thing on the RICE approach, the creator of the RICE approach has even acknowledged that it is no longer the best approach to managing injuries.

Injured? Hold the Ice and Start Moving

You twist your ankle hiking or pull a hamstring playing pickleball.Chances are you used a popular remedy called RICE. It was once the go-to approach for treating acute injuries like sprains, tendonitis and lower back pain.RICE was a term coined by Gabe Mirkin, MD, who published "The Sports...

www.dartmouth-health.org

Basically, if anyone starts by telling you to follow the RICE method, I’d seek additional opinions because their knowledge is outdated

 

[Air Bear]

I know I’m the one asking for advice on here, but I should add that I have worked in physical therapy and I am an OTA, and have spent a lot of time managing injuries myself and helping out others. With the current evidence out there, I highly recommend AGAINST the RICE method and NSAIDs. I also would avoid the cortisone injection unless you were physically unable to walk or do your job. Cortisone injections really only are helpful for 6-12 months an can cause joint damage, so they’re counterproductive in a way. As far as RICE: Rest is beneficial in that you should avoid things that cause significant pain, but you should pursue exercise that will maintain or increase strength in the surrounding tissues because if you rest them completely, they will just get weaker and more prone to injury. Also, exercise promotes blood flow to the area which will promote healing. Ice is beneficial only during the acute phase of injury for reducing pain, but there are quite a few studies showing it to be harmful to recovery. I would NEVER use ice on a chronic injury, or beyond the first 72 hours for an acute injury. Ice reduces blood flow which is necessary for recovery. I would advise heat application 97% of the time over ice as it increases blood flow, which is essential for an area like tendons/ligaments in the foot which get very little blood flow to start. The whole concept from compression comes from the practice we use for treating swelling. Everything will say to use compression to reduce swelling, but most of the time, there isn’t any real swelling to speak of unless it’s like a major sprain or fracture and in the acute phase, so you should not be wrapping once an injury is chronic (persisting for weeks and beyond). Elevation is the same thing, your chronic injury is not swollen most likely, elevation is useless in this case. Also, it’s debatable as to whether you want to treat each of the symptoms associated with the acute phase of injury such as inflammation and swelling because these are your bodies natural defenses to protect the injured site while it prepares to heal the area. I’d recommend just avoiding activity that gives you more than a 4/10 pain, applying heat daily, and then maintaining all exercise that causes NO pain. So if you can ride a bike, walk in grass, etc. without pain, do that.

That last part of not interfering with the natural process is also why I recommend against NSAIDs. If the pain is that bothersome, I’d recommend using a pain reliever other than an NSAID such as acetaminophen.

Thank you for the info. I am really getting desperate so this is helpful. I feel like the doc's dont want to give info outside of what you find in a medical book, and that book is likely outdated. Everything youre saying makes sense. In my head I suppose I struggle with that Im supposed to exercise it to heal, but exercising it is causing the inflammation. I will work with it and keep in mind avoiding activity that generates a pain greater than ~4/10. What do you think of orthotic inserts? Also going against our bodies natural tendencies? Thanks again and good luck with your process.

 

[Eship]

Thank you for the info. I am really getting desperate so this is helpful. I feel like the doc's dont want to give info outside of what you find in a medical book, and that book is likely outdated. Everything youre saying makes sense. In my head I suppose I struggle with that Im supposed to exercise it to heal, but exercising it is causing the inflammation. I will work with it and keep in mind avoiding activity that generates a pain greater than ~4/10. What do you think of orthotic inserts? Also going against our bodies natural tendencies? Thanks again and good luck with your process.

If the orthotic inserts greatly reduce pain and enable you to walk and therefore improve your foot strength, then they could be beneficial. I am someone who likes minimalist shoes, but I have started wearing some cushioned insoles in my shoes and slippers with insoles when I’m in my house, and it has started to help some. I’d go as cushioned as you need to relieve pain and continue with that until it has recovered, which may take months and months. After a few months of feeling good, I’d gradually shift away from the orthotics and transition back to a more normal footwear.

As far as exercising while minimizing pain, I’d say try to do any walking you may have planned in the grass for extra cushion. See if you’re able to tolerate the elliptical or bike. What I’ve found is it’s easier to not obsess over injury and feel hopeless if I’m able to still exercise without pain. So find whatever form of exercise you can that doesn’t cause pain and pursue that. And while a lot of people say keep it at a 4/10 or less, it is definitely better if you can avoid that pain all together.

It’s easier said than done, but with time, it will heal. For me, I walk all day at work on hard floors and have two little kids that keep me up plus and insatiable desire to be active and outside that keeps me on my feet. So I don’t run right now, but I lift and I keep a fast tempo so that I still get my conditioning in. They I wear my soft and cushioned shoes or slippers the rest of the day, and when I go to bed I put a heat wrap around my foot.

 

[BadDogPSD]

Do you have a diagnosis? My ball of foot pain turned out to be Morton's Neuromas, likely caused by wearing boots that were too narrow (trying to avoid heel slip). Metatarsal pads & custom orthotics help.

 

[Eship]

Do you have a diagnosis? My ball of foot pain turned out to be Morton's Neuromas, likely caused by wearing boots that were too narrow (trying to avoid heel slip). Metatarsal pads & custom orthotics help.

Don’t have a diagnosis from an MD, just from PTs that I work with. Metatarsalgia is a general, catch all term it seems, but often the treatment is similar. I’ve been doing cushioned insoles at all times that I’m on my Dee for the last two weeks and it has slightly helped, but that is progress. I know foot injuries take a long time to heal as I’ve successfully dealt with plantar fasciitis in the past

 

[Eship]

Update: the pain at the ball of my foot has gone down a bit with initially wearing more cushioned shoes/slippers all the time. I then reached a point where it started to come back and I found that spending a little more time barefoot actually helped reduce the pain again. Now, I’ve realized that the Keen boots that I typically hunt in, were the same ones I was wearing when my inner ankle starting hurting as well as when the ball of my foot started hurting. Just recently I put the same Keens back on and immediately noticed they aggravated my ankle, Achilles, and ball of my foot. They have a very thick sole and a good bit of heel drop, so I think I need to switch to a more minimalist, zero drop boot. I am used to the zero drop because that is all I wear for regular shoes.

With that in mind, what would everyone recommend for zero drop boots? I’m open to all options