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What is a Metatarsal Pad?
A metatarsal dome (sometimes called a met dome, metatarsal pad, met pad or Morton’s Neuroma pad) is a small soft device used to assist in reducing inflammation associated with a Morton’s Neuroma. The met pad can be useful for many other forefoot pathologies. You can purchase the metatarsal pad in small, medium and large sizing. The metatarsal pad works by splaying the metatarsal heads and therefore offloading the inflamed plantar nerve.
What is a Morton’s Neuroma?
A Morton’s Neuroma is inflammation of the intermetatarsal plantar nerve in the front of the foot. A Morton’s Neuroma usually occurs between the 2nd and 3rd or 3rd and 4th toes. It is caused by compression of the metatarsal heads (bones), which essentially impinges the nerve and can cause significant amounts of pain. Metatarsal pads are often used to reduce the load in the forefoot and therefore assist in reducing inflammation.
If you are have a Morton’s neuroma you may experience the following symptoms;
- Pins and needles or a burning sensation in the ball of the foot
- The feeling that you have a small pebble or marble under your foot when barefoot
- Pain when the area is compressed (by footwear) – and thus relief when shoes are removed
How is a Morton’s Neuroma diagnosed?
Your Podiatrist will use the following assessments to diagnose your foot pain;
- A thorough history of your pain
- A gait and foot posture assessment
- Range of motion assessment (joint movement testing)
- Compression of the metatarsals
- Palpation of the nerve
Sometimes your podiatrist may opt to send you for an X-ray or ultrasound, if the diagnosis is uncertain or unclear.
How do yo get a Morton’s Neuroma?
A Morton’s neuroma usually develops due to varying contributing factors, some of these may include;
- Narrow footwear compressing the metatarsal heads
- Increase in physical activity
- Wearing high heels
- Increased pressure in the ball of the foot
Who is at risk of developing a Morton’s Neuroma?
Although anyone can develop a Morton’s Neuroma, there are some people who are at a greater risk. These include;
- People who regularly wear high heels or narrow/closed shoes.
- People who have foot deformities including; hammer toes, bunions, high arches and flat feet.
How is a Morton’s neuroma resolved and what are metatarsal pads?
There are various methods used to treat a Morton’s Neuroma, these may include;
A change in footwear – It is recommended to wear shoes with a wider toe box, to discourage compression of the forefoot. High heels are to be avoided, as they place a high amount of pressure on the forefoot. Your Podiatrist can make specific shoe recommendations for you.
Offloading devices – Your podiatrist may make use of a metatarsal dome or pad to offload the ball of the foot and therefore begin to reduce inflammation.
Icing the affected area – This may help to reduce inflammation in the foot.
Strapping of the foot – Your Podiatrist can strap your foot to offload the ball of your foot. The strapping can be left on for upto 4 days and usually provides significant relief to the foot. Unfortunately this is a temporary solution.
Biomechanical assessment – It is possible that your gait (the way you walk) may be contributing to the pain and inflammation in your foot. Your Podiatrist can assess you and help to identify whether you are placing unnecessary stress on the metatarsal heads.
Orthotics – can be used to redistribute the plantar pressures and therefore offload the forefoot and allow the inflammation to settle. Your Podiatrist can issue a device that is designed specifically to your foot, which will support your foot and help you to overcome your pain. Orthotics have proven to be very successful when it comes to foot pain.
Activity modification – Exercise can exacerbate inflammation associated with metatarsalgia, so often rest is needed to allow healing. Low impact exercise, such as cycling or swimming is often okay, as it does not place a direct load on the ball of the foot.
Dry needling – Dry needling is often used as a treatment in conjunction with others to help relieve symptoms.
Massage and stretching of surrounding muscles – Like dry needling, these methods can be used as part of a treatment plan to ease inflammation.
Cortisone injection – Occasionally, if all other methods have been exhausted and the inflammation will not settle, a cortisone injection may be used. The procedure requires the injection to be administered between the metatarsal heads, and can be uncomfortable.
Local anaesthetic – Along with the cortisone (steroid) injection, sometimes a local anaesthetic can be administered to the affected location in order to reduce the symptoms.
Do metatarsal pads work?
Yes! Research has proven that metatarsal pads are thoroughly successful in treating various types of forefoot pain. For example, A study conducted by Landorf et al. (2020) found that metatarsal pads can reduce plantar pressures in people with forefoot pain (p. 1).
Although this article was specific to the treatment of forefoot pain in older people, it demonstrated that when positioned 5mm from the metatarsal heads (proximally) the metatarsal pad made the most significant reduction in plantar pressures distal to the metatarsal heads. This indicates that metatarsal pads are successful in reducing forefoot pain when placed in a specific location.
Metatarsal Domes (or Met Domes), are a commonly used for treatment of forefoot conditions such as: Metatarsalgia, Plantar plate tears, Morton’s neuroma, Neuroma/ Bursa complexes, Metatarsal Joint Capsulitis and forefoot fat pad atrophy.
While the metatarsal pads are great for treating foot pain, they must be placed correctly to be effective.
Where should metatarsal pads be placed?
Met domes are often used in custom orthotics as well as stuck on to a range of shoes and insoles. Metatarsal domes help to reduce the pressure on the ball of the foot by redistributing the load, giving instantaneous relief.
The Met Dome is easy to fix with a self adhesive backing, allowing you to position it exactly where the support is needed most, it is made from medical grade poron which won’t flatten and is very durable.
Place the pad behind the ball of your foot to off-load weight bearing away from your forefoot. The placement of the metatarsal dome is dependent upon the condition – For example metatarsalgia can present between the 2nd and 3rd or the 4th and 5th metatarsal heads, which will slightly alter the position of the dome. If you are unsure of where to place your metatarsal pad, be sure to click HERE to book online or speak with your Podiatrist.
Most clients find the metatarsal domes to be inconspicuous and comfortable in the shoe as they are small and soft.
Please be sure to specify in your order, left or right foot.
At Foot Centre Group we believe that each and every client is different and will respond differently to treatments. Your podiatrist will take a thorough history of your pain, as well as assess you biomechanically to diagnose your condition as well as assess whether Metatarsal Pads are appropriate for your presenting issues. We assess each and every case individually and decide upon a treatment plan that is specific to our client’s needs.
Make an appointment at this link: https://www.footcentregroup.com.au/book-online/ or by calling our Moorabbin clinic at 03 9553 0044, Edithvale at 03 9772 9579 and Malvern East at 03 9021 2067.