Metatarsalgia Exercises (Ball Of Foot Pain)

This blog post contains the fastest way to cure Metatarsalgia with effective exercises (… which you can perform at home!).

Metatarsalgia is a condition characterized by having pain underneath the ball of the foot.

Area Of Pain

The irritation is usually located between the 2-4 metatarsal phalangeal (MTP) joint.

Causes Of Metatarsalgia

Metatarsalgia is associated with an unaccustomed increase in pressure onto the forefoot.

This may influenced by:

• Running/Jogging
• Increase in body weight
• Poor foot wear (tight shoes, high heels, lack of cushion)
• Walking barefoot
• Longer 2nd toe
• High stiff arch
• Limited Ankle Dorsiflexion
• Tippy-Toe walking
• Fat pad atrophy
• Hyper-Extended Metatarsal Phalangeal joint (Hammer/Claw toe)

What Happens If You Ignore Metatarsalgia?

Failure to address the pain in your foot will likely lead to an altered walking pattern.

In the attempt to compensate for this pain, the body will tend to over load other areas which can potentially result in injury.

How Long Does Metatarsalgia Take To Heal?

Generally speaking – It should take approximately 6-8 weeks with the appropriate management.

---

How To Fix Metatarsalgia

STEP 1: Reduce Aggravation
STEP 2: Address Inflammation
STEP 3: Stay Active
STEP 4: Reduce Pressure on Foot
STEP 5: Improve Circulation
STEP 6: Releases
STEP 7: Stretches
STEP 8: Decompress MTP Joint
STEP 9: Strengthening Exercises
STEP 10: Toe Control
STEP 11: Midfoot Stiffness
STEP 12: Restore Ankle Dorsiflexion
STEP 13: Lose Weight
STEP 14: Build Resilience
STEP 15: Other Causes

STEP 1: Reduce aggravation

First step – stop making the Metatarsalgia worse!

Frequent aggravations will make your foot pain worse.

(… This may effect how quickly you recover from this injury.)

Recommendation: Avoid (or minimize) exposure to any activity that aggravates your symptoms.

This may involve temporarily reducing the amount of walking, running, gym exercises etc. that you expose yourself to.

STEP 2: Address Inflammation

A significant amount of inflammation can make your foot very sensitive and painful.

This may limit the ability to perform the suggested exercises on this blog post.

Here are some simple ways to reduce inflammation:

a) Anti-Inflammatory Gel

Apply an anti-inflammatory gel to the ball of the foot.

Do this 3 times per day.

b) Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

It is recommended that you take an anti-inflammatory medication consistently for at least 7-10 days.

Keep in mind – there are different strengths/types of NSAIDs and is best used if the prescribed medication is appropriate to the severity of the inflammation.

Note: Please consult your Primary Care Provider before taking any medication.

c) Cold Therapy

Apply an ice pack under the forefoot for at least 10-15 minutes.

Do this 3-5 times per day.

Note: Do not apply the ice pack directly to the skin as you may develop an irritation on the skin.

d) Try Natural Products

It is suggested that taking turmeric, ginger, chia seeds and/or fish oil capsules are natural ways to help reduce the inflammation.

(Although it is difficult to say how effective this is at reducing inflammation, it may be worth a try at least!)

e) Cortisone Injection

The cortisone injection consists of a steroid (cortisone) and an analgesic substance.

The aim of the injection is to reduce the inflammation and reduce the pain by numbing the area.

Talk to your Primary Care Provider to see if the cortisone injection is appropriate for your shoulder injury.

STEP 3: Keep Active

To prevent the deconditioning of your body, it is important to keep as active as possible.

If you are able to walk, walk as much as you can comfortably tolerate without making your symptoms worse.

If walking is an issue, consider switching to low impact exercises such as swimming and/or cycling.

sTEP 4: Reduce Pressure on Foot

The following suggestions will help reduce pressure on the foot whilst allowing you to keep active as possible.

a) Walking Pattern

When walking – Reduce the amount of pressure being placed on the ball of the foot as you push off the ground.

b) Use a Walking Aid

Walking aids (such as crutches and a walking stick) can be helpful in taking pressure off your foot.

c)  Use a Metatarsal Support

A metatarsal support is a soft shoe insert that is placed underneath the ball of the foot.

This can reduce pressure in the aggravated area.

STEP 5: Improve Circulation

Improving blood flow to the injured structures can help promote healing.

Try this quick exercise:

a) Toe Scrunches

Instructions:

• Scrunch your toes.
• Hold for 2 seconds.
• Aim to feel a contraction underneath your feet.
• Relax.
• Perform 30 repetitions.

STEP 6: Release Under The Foot

Performing a massage underneath the foot can help with increased blood flow, reduce pain and reduce tension in the area.

a) Massage For Metatarsalgia

Instructions:

• Place a massage ball underneath your foot.
• Apply an appropriate amount of body weight on top of the foot.
• Roll the foot forwards and backwards on top of the massage ball.
• Aim to cover all of the painful areas.
• Continue for 1 minute.

Note: Apply as much pressure as you can comfortably tolerate. (Pressing too hard may aggravate your pain!)

STEP 7: Stretches For Metatarsalgia

Stretching can be helpful in reducing any stiffness in the foot.

a) Toe Flexion

Instructions:

• Sit down on a chair.
• Place your ankle on top of the other knee.
• Pull individual toe forwards.
• Aim to feel a stretch on the top of the toes.
• Hold for 30 seconds.
• Repeat on other toes.

b) Toe Extension

Instructions:

• Sit down on a chair.
• Place your ankle on top of the other knee.
• Pull individual toe backwards.
• Aim to feel a stretch at the bottom of the toe.
• Hold for 30 seconds.
• Repeat on other toes.

c) Ball Of Foot Stretch

Instructions:

• Kneel down on the floor.
• Have the bottom of your toes in contact with the ground.
• Lean your body weight into the toes.
• Aim to feel a stretch at the bottom of the toes.
• Hold for 30 seconds.

d) Toe Spread

Instructions:

• Sit down on a chair.
• Place your ankle on top of the other knee.
• Use your fingers to pull each of your toes away from one another.
• Hold for 30 seconds.

STEP 8: Decompress MTP joint

The Metatarsal Phalangeal (MTP) Joint is located where the ball of the foot is.

With Metatarsalgia, these joints may be compressed.

Here is a simple exercise to decompress this joint:

a) Joint Traction

Instructions:

• Sit down on a chair.
• Place your foot on the chair.
• Hold onto the base of the toe with your finger.
• Pull your toe.
• Hold for 10 seconds.
• Repeat this movement on each toe.

STEP 9: Strengthening Exercises

Strengthening the foot muscles is an important step when addressing Metatarsalgia.

A weak foot has a higher risk of getting injured!

a) Toe Scrunch (Toe Flexion)

Instructions:

• Stand up right.
• Scrunch your toes.
• Push the tip of your toes into the ground.
• Hold for 45 seconds.
• Aim to feel the contraction underneath your foot.
• Scrunch as hard as you can comfortably tolerate.
• Perform 3 repetitions.

b) Toe Push (Neutral Toe position)

Instructions:

• Stand up right.
• Keep your toes flat on the ground.
• Without allowing your toes to curl, push the pads of your toes into the ground.
• Scrunch as hard as you can comfortably tolerate.
• Hold for 45 seconds.
• Aim to feel the contraction underneath your foot.
• Perform 3 repetitions.

c) Toe Push (Toes Extended)

Instructions:

• Sit down on the edge of a chair.
• Bring your foot underneath you.
• Have your toes extended and in contact with the ground.
• Push your toes into the ground.
• Hold for 45 seconds.
• Perform 3 repetitions.

STEP 10: Toe control

When walking, having a good control of your toes will minimize excess pressure being placed on the ball of the foot.

a) Toe Spread/Squash

Instructions:

• Spread your toes as far as possible.
• Then – Squeeze your toes together.
• Do not flex or extend your toes as you perform this exercise.
• Repeat 20 times.

b) Alternate Toe Lift

Instructions:

• Position 1: Lift up your big toe whilst pushing the other 4 toes into the ground.
• Position 2: Push your big toe into the ground whilst lifting the other 4 toes.
• Transition smoothly between these 2 positions.
• Keep your foot still. Your toes should be the only thing that is moving.
• Repeat 30 times.

STEP 11: Midfoot Stiffness

If your midfoot is locked in high arched position, this can lead to increased pressure placed on the ball of the foot as you walk.

Ideally – the midfoot should splay out as you walk.

Try these exercise to help loosen up the midfoot region:

a) Loosen up Midfoot

Instructions:

• Sit down on a chair.
• Place your ankle on top of the other knee.
• Hold the midfoot with one hand.
• Using your other hand, place your thumb under the base of the big toe and the other fingers on top of the base of the pinky toe. (See image)
• Whilst anchoring the midfoot still, proceed to rotate the forefoot away from you.
• Perform 30 repetitions.

b) Midfoot Loading

Instructions:

• Stand up right.
• Place a small block underneath the ball of your foot.
• Keep your toes completely relaxed.
• Lean your body weight into the inner side of the forefoot.
• Perform 30 repetitions.

c) Forefoot Dome

Instructions:

• Place a massage ball underneath the ball of the foot.
• Aim to wrap your forefoot around the top of the ball.
• Aim to feel a muscular contraction underneath the forefoot.
• Hold for 30 seconds.

TIP: Gain a good sense of how this feels. Try to reproduce this sensation as you are walking to help reduce pressure on the ball of the foot.

STEP 12: Restore Ankle Dorsiflexion

Ankle Dorsiflexion is the movement where the ankle (Talocrural joint) is bent in a backwards direction.

Having an adequate amount ankle dorsiflexion is important for a normal walking pattern.

Poor ankle mobility can lead to the increase in pressure on the ball of the foot which can potentially lead to developing Metatarsalgia.

a) Gastrocnemius Stretch

Instructions:

• Stand in front of a wall.
• Place your forefoot onto the wall.
• Aim to get your heel as close to the base of the wall as possible.
• Keep your knee completely straight.
• Lean your hips towards the wall.
• Hold for 30 seconds.
• For more stretches: Gastrocnemius Stretches

b) Soleus Stretch

Instructions:

• Sit down on a chair.
• Slide your heel all the way backwards.
• Make sure to keep your foot completely flat on the floor.
• Shift your bodyweight onto this leg.
• Move your knee forwards.
• Hold for at least 30 seconds.
• For more stretches: Soleus Stretches

c) Ankle Dorsiflexion

Instructions:

• Attach a resistance band to something behind you.
• Loop the band around your ankle.
  • Make sure the band is below the bumps on side of the ankle.
• Move away from the anchor point as to increase tension in the band.
• Assume the lunge position with your ankle on a bench. (See above)
• Lunge forward.
• Do not allow for your foot arch to collapse.
• Repeat 30 times.

Check out this blog post for more exercises to improve Ankle Dorsiflexion:

See Post: Ankle Dorsiflexion

STEP 13: Reduce body Weight

If you are overweight, consider reducing your body weight to reduce the excess pressure being placed on the foot as you walk.

Please seek help from a professional if you require assistance with weight loss.

STEP 14: Build Resilience

By this stage of your rehabilitation, the pain associated with the Metatarsalgia should be under control.

To build resilience in your foot – It’s time to progressively load the injured structures.

(Note: The following exercises are designed to place more pressure on the ball of the foot. For this reason – it is possible that they may aggravate your pain. Please be careful!)

a) Heel Raise

Instructions:

• Stand on both feet.
• Hold onto something for support to take some pressure off your feet.
• Raise your heels off the floor.
• Perform 30 repetitions.
• Progression: Reduce support from the arms.

b) Single Heel Raise

Instructions:

• Stand on one foot.
• Hold onto something for support to take some pressure off your foot.
• Raise your heel off the floor.
• Perform 30 repetitions.
• Progression: Reduce support from the arms.

c) Try Bouncing/Hopping/Jumping

d) Try Jogging/Running

e) Gradually return the activities that caused the issue in the first place.

STEP 15: Other Causes

There are other conditions that present as pain in the ball of the foot.

a) Stress Fracture

Repetitive pressure on the bones of the foot can lead a stress fracture in the metatarsal bones.

b) Morton’s Neuroma

This is an enlargement of a nerve between the metatarsal bones.

c) Arthritis

This is the degeneration of the joints in the foot.

d) Sesamoiditis

This involves inflammation of the bones and tendon at the base of the big toe.

e) Nerve Pain

Irritation to certain nerves can result in pain in the ball of the foot.

My Recommendation: If you suspect that you have any of the above conditions, please seek guidance from a health professional.

---

Conclusion

Follow the steps suggested on this blog post to cure your Metatarsalgia as quickly as possible.

---

---

Disclaimer: The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment. Use of the content provided on this blog post is at your sole risk. Seek guidance from a healthcare professional before attempting any exercise. For more information: Medical Disclaimer.