METATARSALGIA AND STIFF SHOES: A GUIDE TO FOREFOOT PAIN RELIEF
- 6 days ago
- 3 min read
What Is Metatarsalgia?
Metatarsalgia is pain or discomfort across the ball of your foot, just under the metatarsal heads. If one or more of these bones sit lower than the others, they may be under more pressure for longer, which may cause pain or even stress fractures. Common symptoms are burning, aching, sharp pain, or feeling like you’re walking on a pebble.
This problem often gets worse when the front of your foot bends too much, especially as you push off while walking or running.
Why Is Stiffening Your Shoes Recommended for Metatarsalgia?
Most athletic and walking shoes are made to bend at the ball of the foot, which helps with pushing off to propel you forward. This is great for healthy feet, but it can put more pressure and strain on painful areas in the front of the foot.
Stiff forefoot shoes help by:
Limiting bending at the ball of the foot
Reducing pressure on inflamed metatarsals
Acting like a splint to calm irritated tissues
Allowing painful areas time to recover
For this reason, healthcare providers often prescribe stiff shoes for metatarsalgia, forefoot neuromas, and limited motion of the big toe joint (hallux limitus).
What Is Considered a Stiff Shoe?
A stiff shoe does not bend easily at the ball of the foot when you try to twist or bend it with your hands. Unlike flexible athletic shoes, stiff shoes transfer force forward rather than allowing the shoe to fold near the front. We have a guide that explains how to test this, you read more about it here.
If you can’t find a comfortable, stiff shoe or sandal, a Pedorthist can add a spring plate to your footwear.
What Is a Spring Plate?
A spring plate is a thin, stiff insert, usually made from carbon fibre that helps limit movement in the front of your foot. It can either be placed under a removable footbed (transferable) or built into the middle of the shoe as a modification (permanent).
Transferable Spring Plate
The benefit of using a transferable spring plate is that you can move it from one shoe to another assuming the shoe has enough room in the toe area to accommodate it. Your shoe should also have a removable insole so you can place the plate underneath, keeping it from directly contacting your foot therefore making it more comfortable to wear. When it fits well, your forefoot feels almost splinted, and there is minimal bending at the ball of your foot.
Permanent Spring Plates
Some people find the insert under the footbed uncomfortable and need it built into the middle of the shoe instead. The downsides are that this option costs more, and you can’t move the plate between shoes. However, this allows you to choose a shoe that fits well and you like instead of being restricted to footwear that can accommodate a transferable spring plate.
Embedded directly into the shoe’s midsole
Cannot be transferred between shoes
More expensive, but often better tolerated
Do Stiff Shoes Cause Heel Slippage?
One drawback of using a spring plate is that your heel may slip out of your shoe more easily. When your foot tries to bend, the stiff shoe doesn’t move with it. This happens more often with slip-on shoes, so we suggest using a spring plate in lace-up shoes instead. You can also look for a rocker shoe with a turned-up toe. This feature is now common in many running and walking shoes, such as those from the Hoka brand.
What Is a Rocker Sole?
A toe spring is the upward curve at the front of a shoe that helps your foot move forward as you push off. Similar to adding a spring plate, a Pedorthist can make a genuine rocker sole by removing the outer sole or adding it inside the midsole of a shoe.
Benefits of rocker soles include:
Reduced pressure under the ball of the foot
Smoother forward motion
Improved comfort when forefoot flexibility is limited
Some people say that at first, wearing a rocker sole feels like their “toes are falling off the end of the shoe” when they push off. However, most get used to this feeling over time.
Who Benefits Most From Stiff Forefoot Shoes?
Those with:
Metatarsalgia
Forefoot neuromas
Hallux limitus
General ball-of-the-foot pain
Post-surgical care option when transitioning from post-op shoe to regular footwear after bunion, hammertoe, and other forefoot surgeries
Treatment of turf toe, forefoot stress fractures, sesamoiditis, and Lisfranc injuries
Protection and toe off assistance for pathologies including rheumatoid arthritis, hallux rigidus, Freiberg’s disease, diabetes, and forefoot amputations
Our Pedorthists can help you with shoe modifications and recommendations! If you’ve been told to get a spring plate, you can book an appointment online or check our list of local shoe retailers to find a store that sells stiff shoes in your area.
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