Ball of the Foot Pain
Predislocation Syndrome Treatment [Causes & Best Home Treatment]
Predislocation Syndrome Treatment: Top causes are #1) Hammer Toes, #2) Bunions and #3) Crossover toes. These can lead to plantar plate rupture, STOP IT!
- 2nd toe joint pain can be improved with a few simple treatment changes.
- We are foot doctors & we see this problem get better almost every day.
- The goal is to solve this problem without medication or surgery if at all possible.
So, let’s GO!
- Metatarsalgia: which means generalized foot pain without a specific cause.
- Second toe capsulitis: this is the inflammation of the second toe joint capsule.
- Capsulitis is related to hammertoe formation, and can lead to a plantar plate tear. There is some overlap between these three disorders. As they get worse tearing and ligament damage can occur.
- Morton’s neuroma: this is the damage and inflammation to the nerves between and underneath the metatarsal joints.
- Fat pad atrophy of the ball of the foot: this is the loss of cushioning in the ball the foot.
So, click on the photo gallery to see the specific causes of your ball of the foot pain!
Click on the photo gallery to see the specific causes of your ball of the foot pain!
Causes of Pre-dislocation syndrome:
- Most commonly a bunion forms and causes upward dislocation of the 2nd toe.
- This can frequently be due to shoe pressure.
- A shoe cause a bunion to form and cause the 2nd toe to move upward.
Anatomy of Pre-dislocation Syndrome:
- The ligament that holds the 2nd toe down is called the plantar plate.
- As time goes on this ligament can simply elongate ad rupture.
Conservative Pre-dislocation Syndrome Treatment:
- Stabilize the joint with tape- perform a figure eight loop around the top of the base of the toe that looks like one of those support the troops ribbons(do this with tape). Use half inch cloth tape, or even duct tape works (just split it down the middle).
- You can also get yourself an over the counter hammertoe splint to brace the toe properly.
- Cut out some felt in a U shape around the bottom of the big toe to offload the metatarsal phalangeal joint. Any cutout in felt that offloads the peak pressure area will work in reducing further pain and inflammation and give the plantar plate a chance to heal.
- Perform icing, elevation and take a two week course of anti-inflammatory medication to start too cool down the swelling in the digit. These treatments are not just to control to the pain, but to reduce the swelling which will lead to faster healing times.
- Calf, plantar fascia and ankle stretching is essential to the healing process.
Shoe gear for Pre-dislocation Syndrome
- This is essential! Your footwear is very heavily tied into why you developed the problem in the first place. If poor or not perfect footwear choices are not the cause, then they are at least heavily contributing to the problem.
- Avoid walking in poorly supported shoes like sandals, moccasins or flats. It is also a good idea to get rid of high heels if you are a lady (I know, I know- I tried!)
- Get yourself some stiff soled shoes- running shoes work best in this case. Make sure you use a Brannock device to measure the foot width, foot length and arch length of your shoe. Get some help from your Podiatrist in measuring your shoe gear.
Predislocation Syndrome Surgery:
- This line of conservative therapy should be attempted for at least a good two to six months to give the plantar plate a chance to heal. If it does not – then you should move onto injection therapy to attempt to resolve the inflammation in the joint.
- The danger with a cortisone shot is that while it will remove the pain initially and start decreasing the inflammation which is essential to healing, it will on the other hand weaken the already damaged ligaments and tendons in the area.
- The injection of cortisone and dexamethasone phosphate should be injected from the plantar aspect (this is where the plantar plate tear is located). Injecting into the MTPJ will likely not be effective as this is not the primary site of inflammation. It is essential that the patient keep the toe well protected with tape, padding, orthotics, shoe wear, icing and stretching. The tendon will be susceptible to further damage at this point. There is a real chance of rupture of the plantar plate occurring so this should not be taken lightly.
- -Injection therapy is the last choice before surgery must be considered.
For more on Pre-dislocation Syndrome Treatment:
Ball of the Foot Pain Treatment Infographic:
Ball of the Foot Home Treatment:
- Consider taping, orthotics and great shoes as a combination to fix your foot problem.
- Products are not always necessary to fix your problem.
- The key is correcting the biomechanics that are leading to forefoot overload. Foot overload means too much pressure in the ball of the foot.
- Generally something called ankle joint equinus can lead to a too much pressure in the ball of your foot. This means your ankle is not flexible enough to move up and down.
- Ball of the foot pain treatment consists of two phases, first is control inflammation, next is to control bio-mechanics.
Remove Control Inflammation:
Massage & Ice Products:
- The metal ball is one of my personal favorites.
- This works great for your arch, less for the ball of the foot.
- These can help relax the arch or heel ligaments, leading to less pressure in the ball of the foot.
- Pills, creams and ice will never completely fix your problem alone. What they will do is reduce the pressure on the area.
Menthol Based Gels:
- Biofreeze is one of our favorites.
- These gels have been studied to work 2x as long as ice.
- This works great for the ball of the foot.
- Consider using these as options when resting on the couch or going to sleep at night.
- These can work great for loosening your muscles.
- This is means for your hamstring and calf muscles. This can loosen the ankle tightness putting pressure on the ball of your foot.
- This allows less tightness and pressure on the ball of your foot.
Ball of the Foot Stress Relief.
- The key is to prevent future pain.
- If you can get rid of the pain and swelling, this will let you start walking normally.
- If you can walk normally, the vast majority of your pain should gradually start to go away.
- This means proper cushion, proper stability and pressure relief from the front of your foot.
- This will relieve pressure from your big toe, your 2nd toe, your Morton’s neuroma, your plantar plate, hammer toes and joint capsules.
Best Metatarsalgia Shoes:
- Getting a great supportive pair of shoes will make sure that there is pressure removed from the ball of your foot.
- This is especially important if you have a metatarsalgia, a Morton’s neuroma, 2nd metatarsal overload syndrome and capsulitis!
- Consider shoes combined with a good supportive orthotic for best pain relief!
- The following link will show you what our favorites are.
Best Ball of the Foot Insoles:
- These are our recommended orthotics & insoles.
- There are different types for different shoes.
- Women’s shoes usually need a less bulky orthotic, but allow for less correction.
- A full length orthotic requires a running shoe, boot or comfortable walking/dress shoe.
Best Full Length Orthotics:
- Full length orthotics are the most recommended type for ball of the foot pain.
- Be aware that if they are too uncomfortable, it might be worth starting with a less corrective pair.
- Eventually you can then work your way up to these.
Best Dress Shoe Orthotics:
- These are a stronger option for shoes with tight dress shoes.
- Just be aware that less corrective orthotics & tight shoes are usually not a good combination.
Best 3/4 Length Orthotics:
- These may be a good option for ball of the foot if the full length orthotics are too tight or too uncomfortable.
Get A Great Dynamic Stretch:
- It is possible to stretch on your own, but these products can also really help!
- Personally I have the stationary block set up in my kitchen to stretch every day multiple times while getting my coffee!
- This will take pressure off of the ball of your foot.
Ball of the Foot Pain