11/7/2011 9:16 PM
I saw a number of cases of sub-2nd metatarsalgia pain today in the office. This varied from mild pain (bruise sensation) to swelling and more severe pain with activity limitations. The quickest modification to add to these patients' orthotics is an 1/8" thick forefoot extension beneath the top cover with a cut out beneath the 2nd met head. Another modification could be a metatarsal bar. These can both be added to a forefoot rocker shoe, surgical shoe, or walking boot for higher levels of pain in order to decrease pressure through the forefoot.
The E-Journal last week describes the importance of the shoe rocker in severe cases of metatarsalgia and the placement of the rocker is directly related to the clinical outcomes. Click here to review the article.