Forefoot pain - metatarsalgia causes and treatment

Forefoot pain: Acute Metatarsalgia causes and treatment

by David Pope

Metatarsalgia is characterised by pain and sensitivity to pressure under the metatarsal heads with standing, walking or running. In this video I filmed with Nick Torrance of Balance in Motion Physio in Bondi, Nick discusses the causes of metatarsalgia and how to settle down acute pain in the forefoot. A few years ago the foot used to be one of my least favorite areas to treat, more than likely because it was an area I was the least confident with my surface anatomy, testing, diagnosis and then knowing how to treat one of the numerous conditions that patients come in with. This is one of the reasons I wanted to get experienced clinicians like Nick on Clinical Edge, to share their extensive knowledge and skills around the foot (amongst other areas), and give really detailed, specific advice on how you can identify and treat forefoot pain

Since improving my knowledge via people such as Nick Torrance, Russell Wright, Robyn GantDr Linda-Joy (LJ) Lee as well as at Griffith University on my Masters of Musculoskeletal and Sports Physio I now really enjoy treating patients with foot pan, and feel much more confident in my palpation, diagnosis and achieve much better results with my foot pain patients. Here is a quick video on metatarsalgia, which is one of many highlights from the video Nick presented on Advanced Forefoot Injury Management, so I hope you enjoy these few quick tips.

 

 

This video is part of the video series Forefoot – Advanced Injury Management with Nick Torrance on www.clinicaledge.com.au

Video Outline – Forefoot – Advanced Injury Management with Nick Torrance 

The forefoot is a very common area of injury in your patients that are runners, have recently changed their footwear or taken up a new sport. In the first video series on the forefoot with Nick Torrance, already released and available for Clinical Edge members, he explored the bony and surface anatomy of the rear foot, midfoot and forefoot, the different arches of the foot and the bones that make up these. Nick covered in detail:

  • anatomy and surface anatomy of the muscles that support the medial longitudinal arch, lateral longitudinal arch and transverse arch
  • assessment of the foot in standing
  • 1st MTP assessment
  • assessment of the foot through the gait cycle
  • assessment of balance
  • active and passive movement tests for the foot and ankle
  • Testing muscle strength
  • Assessment and treatment of
  • Hallux Limitus
  • Hallux Valgus
  • Sesamoid injuries
  • Metatarsalgia
  • Morton’s neuroma
    This second video series Forefoot injuries – Advanced Management follows on from the first video series, building on your knowledge of anatomy, testing and treatment skills. (If you haven’t enjoyed the video series Forefoot Injuries yet, you will find it really helpful to watch Part 1 prior to this Advanced series).

In Forefoot – Advanced Injury Management, Nick will take you through

  • Postural foot deformities including Pes Planus and Pes Cavus and footwear that is indicated for each of these (and you may find this advice quite surprising)
  • Beyond the foot – Other musculoskeletal contributors to forefoot pain
  • Mechanism of injury – how the forefoot may become injured
  • Order of treatment – treating the forefoot as a part of the whole foot. Treat the forefoot, midfoot or rearfoot first?
  • Improving and maintaining dorsiflexion to offload the forefoot
  • Neuromuscular compression and joint stiffness in the mid foot
  • Incorporating dry needling in the lower limb – including Tibialis Posterior, Flexor Digitorum Longus, Tibialis Anterior and other muscles
  • Metatarsalgia – advanced treatment strategies
  • Specific instruction on how to fit and use metatarsal domes
  • Taping for the metatarsals
  • Shoe advice for metatarsalgia
  • Foot retraining and lumbrical strengthening
  • Specific stretches for the foot
  • Treating chronic metatarsalgia
  • Treatment of Morton’s neuroma
  • Addressing digital deformities such as claw toes and hammertoes
  • Stress fractures in the foot – identification and management
  • Sesamoiditis – advanced treatment strategies
  • Retraining normal movement of the foot
  • Using orthotics for sesamoiditis
  • Advanced Hallux Limitus and Valgus treatment
  • High heel advice for your forefoot pain patients – do they need to abandon high heels, or what high heels may still be appropriate
  • Putting your assessment and treatment together to get the best results with your forefoot patients

Find out more about assessment and treatment of Forefoot injuries at www.clinicaledge.com.au where members get access to the entire library of more than 150 clinically relevant videos

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