Toe Woes

January 12, 2014

Rebekah asked The Guru for the following Physiotherapy Advice:

Dear Guru,

Nearly 2 years ago while dancing (Salsa) I suddenly felt as if there was something stuck on my shoe roughly under the 2nd metatarsal head. I hadn’t injured it in any way and don’t know what triggered it (5 years dancing with no problems before). Afterwards initially I only noticed this feeling when dancing or wearing heels, but it became a general bruise-like ache in that area of the foot, especially when walking barefoot. My doctor said I may or may not have a Morton’s Neuroma (they couldn’t see one), the joint is inexplicably inflamed (fluid was visible with MRI), the fat pad is slightly thinner than the others, and after initially saying carry on and take Ibuprofen, they suggested rest. Despite quitting all activities other than basic necessary walking around it has become worse. I had a corticosteroid injection but it didn’t help.

When I have tried to wear low heels, or my feet are cold, the pain is worse and feels as if the 2nd metatarsal is the lowest part of my foot and only bone taking any weight (best way to describe the pain!) In the last year I have lost flexibility in the 2nd toe joint- I cannot bend the toe back fully and even a small bend is painful, especially when weight bearing.

I was told physio can’t help but the painful joint has meant even low intensity activity like Yoga is now difficult. Doctors have said just never again do anything that makes it hurt, but that’s basically everything. Do you know if Physio could help or have any other advice, or ideas if this will ever get better? In case it helps I have quite wide feet (but never wear pointy shoes) and am a bit flat footed?

Thanks very much,


January 12, 2014

Hi Bex


You’ve got a dropped metatarsal head – and that’s why your feel like you are constantly loading it up….because you are! It’s the first and one of the last things to hit and leave the ground.

It’s having to take all the ground load and move excessively because the other 4 MTHs don’t have to do half as much. It’s why it’s also becoming stiffer, because it’s overloaded and over stretched.

Please, please, please go and see a good podiatrist. I’m sure they are absolutely the people you need to see to be prescribed a custom orthotic with a cut out around your 2nd MTH.

Good Luck!

Guru Responded

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