Choosing between a metatarsal pad and a metatarsal bar is sometimes difficult. Most off -loading studies use the metatarsal pad, but seldom provide the specifics regarding the size or material. A few studies have referenced the metatarsal bar, but historically the metatarsal bar has been a bar attached to the outsole of the shoe. At Prolab, we offer two choices of off-loading on the custom orthotic.
The metatarsal bar is an 1/8″ layer of poron at the distal edge of the plate. It is different than a metatarsal pad because the high point is not as acute. Because it is present across the entire distal edge, it offers more diffuse off-loading for all the metatarsal heads , and less focus on the 2,3 metatarsal heads, which is where the metatarsal pad is most effective.
The metatarsal bar is less noticeable for many patients, but it may lead to difficulty with shoe fit due to the increase in bulk across the entire forefoot.
It is definitely an alternative to consider whenever off-loading of the metatarsals is one of your orthotic goals.