Updated: Feb 26, 2018
  • Author: Britt A Durham, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Practice Essentials

Metatarsalgia is a common overuse injury described as pain in the forefoot that is associated with increased stress over the metatarsal head region. Metatarsalgia is often referred to as a symptom, rather than as a specific disease. Common causes of metatarsalgia include interdigital neuroma (also known as Morton neuroma), metatarsophalangeal synovitis, avascular necrosis, sesamoiditis, and inflammatory arthritis; however, these causes are often diagnosed separately. (See also the Medscape Reference articles Physical Medicine and Rehabilitation for Morton NeuromaSurgery for Morton Neuroma, and Avascular Necrosis.)




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Athletes who participate in high-impact sports that involve the lower extremities commonly present with forefoot injuries, including metatarsalgia. [1, 2]


Functional Anatomy

Body weight is transferred to the foot by gravity. This transfer of force is increased to the forefoot during the mid-stance and push-off phases of walking and running. [2, 3] In the forefoot region, the first and second metatarsal heads receive the greatest amount of this energy transfer. Peak vertical forces reach 275% of body weight during running, and a runner may absorb 110 tons per foot while running 1 mile. [2] Pressure studies have shown that runners spend most of the time weighted over the forefoot while running.


Sport-Specific Biomechanics

Athletes who take part in high-impact sports that involve running or jumping are at high risk of forefoot injuries. [1, 2] Although track-and-field runners are exposed to the highest level of traumatic forces to the forefoot, many other athletes, including tennis, football, baseball, and soccer players, often present with forefoot injuries.