Hikers Guide to Metatarsal Pain

Hikers Guide to Metatarsal Pain

Metatarsal pain, also called Metatarsalgia (met-uh-tahr-SAL-juh) occurs when the ball of your foot becomes inflamed as a result of jumping, running, or hiking. The feeling is similar to having a pebble in your shoe under the ball of your foot. This is a temporary condition that usually treatable with ice, rest, and anti-inflammatories. Wearing a shoe insole or metatarsal pad can also relieve the pain and prevent a recurrence.

Symptoms

The key symptom is pain in the ball of your foot when walking barefoot or in shoes. It’s common among people athletes and people who lead an active lifestyle that involves jumping, climbing, and hiking. Metatarsal pain comes from the five bones at the bases of the toes, the metatarsals.

Other conditions known as Morton’s neuroma, arthritis, bunions, hammertoe, or even gout can cause metatarsalgia-like symptoms. If in doubt or if the symptoms persist, consult medical attention.

Causes

Metatarsal pain can arise from placing too much weight and force on the ball of your foot. Considered an overuse injury, metatarsal pain often results from the repeated impacts that your feet take during sports, like running, hiking, and jumping.

There are a number of contributing factors that can cause metatarsal pain, including:

  • Being overweight
  • Tight calf muscles
  • Weak ankle muscles, particularly after an injury
  • Hammertoe deformity
  • Poorly cushioned shoes
  • Footwear that is too tight or too loose

Many of us suffer from one or more of the conditions listed above at some time or another. This can make the cause of metatarsal pain hard to pin down since multiple factors are often involved.

Treatment

Most metatarsal pain is temporary and goes away with rest, icing, and taking anti-inflammatories like ibuprofen until the pain dissipates. This can take some time, however. If you can’t wait for the symptoms to disappear completely there are a number of measures you can take to lessen or eliminate Metatarsal pain. While you may have to change the shoes you wear eventually, you can try out a number of less expensive and drastic alternatives first. Longer-term, you may find it necessary to replace your hiking shoes or increase your foot flexibility and strength through exercise or physical therapy.

Replacement Insoles

Replacing your insoles with ones that have a higher arch can help dissipate the force of a footstrike over a greater surface area and away from the ball of your foot. It helps to get an insole with a pronounced heel cup to any prevent foot rolling which can exacerbate the pain.

For example, when I switched from a pair of very beatdown and thin Superfeet Carbon insoles with a fairly low arch to a new pair of firm Superfeet Green insoles with a higher arch, I felt immediate pain relief in the ball of my foot. It took a little while to have my feet get used to wearing the green insoles again (I wear them in winter), but it made the condition much more tolerable while I bombed my metatarsals with anti-inflammatories. TreadLabs also makes three grades of Firm insoles: Firm (called Ramble), Extra Firm (Pace), and Ultra-Firm (Dash). Treadlabs insoles are less expensive than Superfeet over the middle-to long term because their foot covers are replaceable and the entire insoles don’t have to be thrown out when they wear out.

Proper met pad placement is important to relieve stress on the heads of the metatarsal bones
Proper met pad placement is important to relieve stress on the heads of the metatarsal bones.

Metatarsal Pads

Another option is to get metatarsal pads (also called met pads) that stick to your feet with adhesive or stick to the bottom of your insoles. For example, you can stick an adhesive-backed metatarsal felt footpad behind the ball of your foot to alleviate metatarsal pain. These felt pads, available in multiple thicknesses – 1/8″, 3/16″, and 1/4″ – reduce pressure on the ball of your foot by supporting the metatarsal bones just behind it. They’re also really sticky when applied to your skin, but they provide immediate relief and you can get a sock over them.

Alternatively, when you find the sweet spot on your foot, you can stick them on the inside of your shoes, tape them on top of an orthotic insole, or on the underside of the insole and get multiple uses out of them. Treadlabs also sells velcro-backed, foam, metatarsal support pads that attach to the bottom of their insoles, allowing you to easily reposition the pads and remove them for cleaning.

Summary

Metatarsal pain, also called Metatarsalgia (met-uh-tahr-SAL-juh) occurs when the ball of your foot becomes inflamed as a result of jumping, running, or walking. It’s fairly common among hikers and runners and usually responds to rest, ice, and taking anti0-inflammatories. Metatarsal pain is an overuse injury caused by repeated impacts. You can further relieve its symptoms by using more supportive insoles or metatarsal pads, although for permanent relief it may be necessary to change your footwear.

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About the author

Philip Werner has hiked and backpacked over 7500 miles in the United States and the UK and written over 2500 articles as the founder of SectionHiker.com, noted for its backpacking gear reviews and hiking FAQs. A devotee of New Hampshire and Maine hiking and backpacking, Philip is the 36th person to hike all 650 of the hiking trails in the White Mountain Guide, a distance of approximately 2500 miles, completing a second round in 2021. Philip is the author of Backpacking the White Mountain 4000 Footers, a free online guidebook of the best backpacking trips in the White Mountains in New Hampshire and Maine. He lives in New Hampshire.

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