how to prevent ball of foot pain in ahtletesBall of foot pain is one of the most common types of pain I see in athletes. Whether you're a runner, soccer player, or dancer ball of foot pain can stop you from doing what you love. Your feet are a wondrous, complex system of bones, joints, tendons, and ligaments designed to work together perfectly. And they must. They have a big job to do. Your feet are small relative to the amount of weight they need to hold up and keep in alignment.

Considering the amount of pounding and abuse they take, it's amazing our feet continue to deliver for us. It's not until we feel pain that we start to examine what we might need to do differently to protect them.

When you do experience pain in the ball of your foot or in other parts of your feet, you might wonder why your running partner seems to glide through it all without a twinge. The truth is your athletic pursuits are only part of the puzzle when it comes to assessing why you have pain in the ball of your foot. In fact people who aren't athletes also get ball of foot pain.

What Do I Mean By Ball of Foot Pain?

Ball of foot pain occurs where the toe bones join the metatarsal bones. It can occur in one spot or all across the ball of the foot. Symptoms can range from sharp or shooting pain when the toes are flexed to tingling or numbness in the toes or it can even feel like you're walking on pebbles.

There are many causes of ball of foot pain. To properly diagnose and treat it, I'll ask you questions about your recent physical activity, watch you walk, determine your foot type, and check the types of shoes you're wearing.

The Role of Foot Structure in Ball of Foot Pain

A big factor in developing foot pain lies in the structure of your feet. Some of us have high arches, some have low arches, and some have no arches. High arched feet and feet with no arches can both cause instability in the foot that leads to ball of foot pain by putting extra pressure on the metatarsal bones. Also, a Morton's toe (the second or third toe longer than the big toe) can lead to this condition when weight shifts to the second or third toes.

How Tight Calf Muscles Affect Foot Position

Tight calf muscles can make faulty foot structure worse by increasing the pressure on the metatarsal bones at the front part of your foot.

How Physical Activity Affects the Foot

Our feet can take a lot of pressure, however, the high jumps during a basketball game and the constant pounding from running can be a primary cause of ball of foot pain. It's important to rest when you first feel the pain and not try to play or run through it since you can do further damage to your feet.

How Being Overweight Can Play a Role in Ball of Foot Pain

Being overweight can increase your risk for ball of foot pain. Every extra pound of body weight creates three extra pounds of force when walking and seven pounds when running. For example, a person weighing 200 pounds would place 600 pounds of force on their feet when walking and 1400 pounds of force when running.

The Role of Shoes in Ball of Foot Pain

One of the easiest things to do to decrease ball of foot pain is to change your shoes. Every sport has shoes designed specifically to prevent foot and ankle injuries most common to it. Basketball shoes worn for running will not protect you from running injuries. Likewise, old worn out shoes will not provide the support needed to prevent pain in the ball of your foot. Even when you're not taking part in your favorite sport it's important to keep in mind that high heels and shoes that are pointy and squeeze the front of your foot can also be a factor in your foot pain.

Common Ball of Foot Pain Conditions

Some of the most common ball of foot pain conditions are:

  • Metatarsalgia - the pain is typically felt on one or more of the five bones (metatarsals) in the mid-portion of the foot.
  • Neuroma - A neuroma is an enlarged, benign growth of nerves, which can occur in various parts of the body. The most common neuroma of the foot is called Morton's neuroma, It develops between the third and fourth toes of either foot. The incidence of Morton's neuroma is eight to ten times greater in women than in men.
  • Sesamoiditis - occurs when the tendons surrounding the sesamoids can become irritated or inflamed. Sesamoiditis is a common condition among ballet dancers, runners, and baseball catchers because of the pressures placed on their feet. A form of sesamoiditis called turf toe is also found among soccer players and kickers in football.

Treatment of Ball of Foot Pain in North Seattle

Acute pain and injury should be treated with ice to decrease swelling. Additional treatment will depend primarily on your diagnosis and foot structure. Orthotics might be dispensed to improve your foot alignment or to relieve pressure on a nerve if implicated in the diagnosis. A program of stretching, often with an Achilles splint, is warranted if you have tight calf muscles. Weight loss may be suggested to relieve pressure on your feet.

New athletic shoes should be purchased annually to ensure they are providing the support you need. Avoid buying lightweight shoes with squishy soles and no solid shank from the heel to the ball of the foot as these will add to your ball of foot pain. Instead, purchase a Hoka One One running shoe if running is your sport. It has great shock absorption with a good shank and a rocker sole to prevent your foot from jamming into the ball of your foot. Everyday shoes should be only one inch in height and have a toe box wide enough to accommodate your forefoot.

Finally, all activity should stop until a diagnosis is confirmed by your podiatrist.

Learn about other types of sports injuries and their treatment here. 

Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.
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