Metatarsalgia: Treating your forefoot pain right

Written by Bianca Charles on September 11, 2019

Last updated September 26, 2019

Metatarsalgia is very broad term that describes pain at the ball of the foot or forefoot region where the metatarsal bones are located. It is usually a result of overuse or faulty foot mechanics leading to persistent stress to the area followed by inflammation of the bone and/or soft tissues.

You can be experiencing pain at the balls of your feet because of various reasons ranging from a deep corn to a stress fracture of the 2^nd metatarsal bone. Pain can stem from all levels of tissue and may be caused by but is not limited to the following:

Pathological callus/corn
Ganglion cyst
Capsulitis
Bursitis
Morton’s Neuroma
Nerve entrapment
Stress fracture
Arthritis

In general, to treat your forefoot pain, you must:

Reduce inflammation

Rest, ice, elevate and massage the area of pain with anti-inflammatory gels and topical creams. If absolutely necessary, a Licensed Chiropodist will prescribe an oral anti-inflammatory to help with manage your pain.

Change your footwear and get custom made orthotics

Wearing tight-fitting shoes with a high heel will only make the problem worse. Rather, wear shoes with a low heel and a wider toe box to reduce compressional stress to the balls of your feet. If the root problem is faulty foot mechanics, corrective custom foot orthotics will help to increase support and stability in the foot and ankle as well as redistribute plantar pressures. Essentially, with a custom orthotic, the goal is to remove excessive pressures from the balls of the feet by improving general foot function and/or controlling foot movement. There a number of different additions a health care professional can make to the orthotic for someone who is experiencing metatarsalgia. A common addition is a metatarsal dome pad or a plantar metatarsal pad with cut-outs. Both work to offload or reduce pressures from the area of concern.

If you are experiencing pain at the ball of your foot, book an appointment with one of our Licensed Chiropodists at Feet First Clinic. The appointment will include a thorough assessment followed by a proposed treatment plan that will get you on the path to pain-free feet today!

Everything You Need for Healthy Feet - All Under One Roof

At Feet First Clinic, we’re always excited to welcome new clients! We’re Toronto’s one-stop-shop for all your foot-related needs. For 15 years, our staff and licensed chiropodists have been helping people with their feet. From foot care to foot pain to foot products – we do it all! Give us a call to ask our friendly staff any questions you may have! Our Toronto foot specialists are ready to help!

Call us at 416-769-3338 or Book Your Assessment Today!

About Author: Bianca Charles

With 15 years of dedicated experience in podiatry, Bianca Carter offers a wealth of knowledge and expertise at Feet First Clinic. Throughout her career, Bianca has worked closely with leading chiropodists, continually deepening her understanding of all aspects of foot care.

Learn more about Bianca Charles

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April 30, 2025

Top Neutral Running Shoes

Finding the best neutral running shoes is an important “step” for runners who want a natural, supported stride. Neutral running shoes are designed for those who don't require extra corrective features and benefit most from balanced cushioning and stability. Many people also look for lightweight running shoes that deliver comfort and speed without feeling bulky. In this guide, we’ll help you find the right pair! Many of these shoes, and others, are available at our Toronto foot clinic, Feet First Clinic, and foot specialists like chiropodists and podiatrists often suggest them for people with a normal gait or who supinate. https://www.youtube.com/shorts/0bVBNNUAUOc What are Neutral Running Shoes? To understand what neutral shoes are, it helps to look at different foot types and the way each moves during walking or running. Foot types are typically defined by the height of the arch and associated gait patterns: Flat feet: Minimal or no visible arch, often leading to overpronation, where the foot rolls excessively inward during movement. Around 40% of runners overpronate, and without the right shoes, overuse injuries like plantar fasciitis can develop. Runners with flat feet should consider stability shoes, sometimes the more restrictive motion control shoe. High arches: A very pronounced arch, often leading to underpronation (also called supination), where the foot rolls outward. Normal arch: A moderate, well-formed arch that’s about “halfway full.” It supports a relatively neutral walking or running gait without excessive rolling inward or outward. Neutral shoes are designed for individuals with a normal arch and a natural gait, meaning their foot doesn't overly roll in (overpronate). Neutral running shoes are also suitable for people with high arches who underpronate. These shoes prioritize cushioning and shock absorption over structural support or corrective features, offering a more flexible and natural ride. Unlike stability shoes or motion control shoes, which are more rigid, built to control motion and guide the foot into proper alignment, neutral shoes allow the foot to move more freely and comfortably, simply because this is okay for a normal arch and a normal gait doesn’t need guidance. The focus is on lightweight materials, responsive cushioning, and smooth transitions from heel to toe. Comfortable neutral shoes are ideal for runners or walkers who have an efficient gait cycle and don’t require additional support to prevent injury. They can also be a good option for individuals with high arches, who often benefit from extra cushioning to protect against the increased impact that comes from less natural shock absorption. How Do Neutral Shoes Prevent Foot Pain? Neutral shoes help prevent foot pain by offering ample cushioning and promoting the foot’s natural motion without interference. For people with normal arches and a stable gait, or high arches, too much corrective structure can actually cause discomfort or alter natural biomechanics. Neutral shoes support a smooth stride while providing the soft, consistent underfoot feel needed to absorb the repeated impact of walking or running. One of the key ways neutral shoes protect against foot pain is by reducing the jarring forces that travel up through the feet and legs with every step via shock absorption. High-quality cushioning materials, such as EVA foam or advanced proprietary foams, spread out impact forces and minimize stress on the heels, arches, and forefoot. This protection helps prevent common issues like plantar fasciitis (heel pain), metatarsalgia (pain in the ball of the foot), and even joint discomfort in the knees and hips. Additionally, neutral shoes are often lighter and more flexible than stability or motion control shoes, which can reduce fatigue over longer distances. With less weight to lift and more natural foot mechanics, you can stay active longer and more comfortably. The result? A smoother, more enjoyable experience every time you move. And your feet aren’t too tired at the end of the day! Top Neutral Running Shoes in 2025 Where do you start when you want to find the right pair? Luckily, we’re going to talk about some of the best options. Some of these are available at our Toronto foot clinic, Feet First Clinic, and come highly recommended by chiropodists and podiatrists. You can always call or visit us to determine what high quality footwear we have in stock at any given time. ASICS Gel-Nimbus 27 The ASICS Gel-Nimbus 27 is a premium neutral running shoe designed for comfort and durability. It features a high stack height of 43.5 mm at the heel and 35.5 mm at the forefoot, providing ample cushioning for long-distance runs and everyday walking. The midsole utilizes ASICS' FF Blast Plus Eco foam, offering a soft yet responsive ride. A PureGel insert under the heel enhances shock absorption, which reduces joint strain. The engineered jacquard mesh upper is both breathable and supportive, contributing to the shoe's overall comfort. Despite its cushioning, the Gel-Nimbus 27 maintains a relatively lightweight profile, making it suitable for daily training. This model is ideal for runners seeking a plush, cushioned experience during long runs or recovery days. But it's not just for runners! It's also ideal for people with foot pain, arthritis, or who want to keep their feet comfy and supported as they go about their daily activities. Its premium cushioning makes it feel like you're walking on a cloud. Whether you're training for a marathon or enjoying a leisurely jog, this shoe offers the support and comfort needed to keep you going. It's also fantastic for non-runners who just want a comfortable walking shoe. Saucony Triumph 23 The Saucony Triumph 23 is another top-tier neutral running shoe with a stacked heel, known for its plush cushioning and smooth ride. It features PWRRUN+ foam in the midsole, delivering a soft yet responsive feel underfoot. The shoe's geometry promotes a natural stride, and the updated upper provides a secure, comfortable fit. Its durable outsole offers reliable traction, ensuring confidence on various terrains. Overall, the Triumph 23 combines cushioning, support, and durability, making it a versatile choice for runners and non-runners alike. The cushioning also delivers great shock absorption, while the mid-rocker sole reduces strain on the forefoot - great for people with high arches and joint rigidity. This shoe is particularly well-suited for runners who prioritize comfort and support over speed. The Triumph 23's design caters to those who spend extended periods on their feet, whether during training sessions or daily activities. Its combination of cushioning and stability makes it a reliable choice for a wide range of runners. Brooks Ghost For those who don’t want a stacked heel, the Brooks Ghost is renowned for its balanced cushioning and reliable performance. This neutral running shoe offers a 12 mm heel-to-toe drop, catering to runners who prefer a traditional feel. Its DNA LOFT v3 midsole provides a smooth, responsive ride, while the engineered mesh upper ensures breathability and comfort. The durable rubber outsole enhances traction, making it suitable for various surfaces. The Ghost 16's consistent performance and comfort make it a go-to option for daily training and long-distance runs. Ideal for runners seeking a dependable and straightforward shoe, the Ghost 16 delivers a comfortable experience without unnecessary frills. Its design focuses on providing a smooth transition from heel to toe, accommodating a variety of running styles. Whether you're a seasoned runner or just starting out, the Ghost 16 offers the support and comfort you need. It's also great for people who wear custom orthotics.

March 13, 2025

Do Flat Feet Cause Bunions?

Flat feet are a condition in and of themselves. However, flat feet also have an impact on future foot health and can lead to other more painful foot conditions. But can flat feet really cause bunions? While it seems unlikely that a toe deformity can be linked to a flat arch, you'd be surprised how interconnected our lower extremities are, especially the feet! Today’s article will explore how flat feet cause bunions, what you can do to prevent them, and how a foot specialist like a Chiropodist or Podiatrist can provide treatment. What are Flat Feet? Flat feet, or pes planus, cause the entire sole or most of it to contact the ground when standing and walking. For some people, this condition can extend into adulthood from childhood (children have flat feet before the arch forms) when the arch fails to form.When you have normal arches, they provide an elastic, springy connection between the forefoot and the hindfoot, allowing forces incurred during weight-bearing to be distributed properly. When these arches don’t exist, this mechanism is disrupted, leading to pain and other complications. What are Bunions? https://www.youtube.com/shorts/sXF8lWHad0g Bunions, or hallux valgus, are bony protrusions that form on the inside edge of the first metatarsophalangeal (MTP) joint at the base of the big toe. They develop when pressure causes the big toe to deviate toward the second toe, resulting in a misalignment of the joint. Emerging research indicates that hypermobility in the midfoot (specifically the mid-tarsal joint between the navicular and the base of the first metatarsal) may be a key underlying factor in the development of bunions, and this hypermobility is often genetic. Common Bunion Causes and Risk Factors: Ill-Fitting Footwear: Wearing the wrong shoes for years is a major risk factor for most foot conditions, especially bunions. Wearing tight, narrow, or high-heeled shoes can exacerbate pressure on the big toe joint, contributing to bunion formation. Your toes need space to splay and rest comfortably! Gender and Age: Women, particularly those over 60, are more prone to developing bunions, generally due to decades spent making poor footwear choices, or possibly due to hormonal influences that affect the ligaments in the foot. Inflammatory Conditions: Diseases like rheumatoid arthritis can cause joint inflammation, which increases stress on the big toe and the risk of bunions. Foot Injuries: Trauma to the foot can alter its mechanics, leading to bunion development. https://www.youtube.com/shorts/KZiVzLyBUMo Flat Feet and Bunions: The Connection If you’re not proactive, the shape of your foot arch can have a big impact on our foot health over time. You may know that flat feet can lead to plantar fasciitis, and you may also know that high arches can lead to back pain, but our arch shape can affect us in countless ways. Let’s talk about the science behind why a flat foot can lead to a painful bunion. It all boils down to flat feet causing an abnormal gait (walking pattern), and the damage caused by walking with that abnormal pattern for a long period of time.The structural anomaly of flat feet and barely having an arch, or no arch at all, can significantly impact foot mechanics—particularly during walking. In a typical gait cycle, the foot pronates (rolls inward) to absorb shock and then supinates (rolls outward) to create a rigid lever for propulsion. Individuals with flat feet often experience overpronation, where the foot remains excessively rolled inward during the push-off phase. The altered biomechanics increases pressure on the first MTP joint, leading to instability and misalignment. Over time, this persistent stress can cause the big toe to deviate toward the second toe, resulting in a bunion. Moreover, flat feet can lead to muscle imbalances that exacerbate bunion formation. Weakness in the intrinsic foot muscles (a group of tiny muscles inside the foot) and the tibialis posterior muscle (a muscle in your lower leg) compromises arch support, worsening overpronation. This chain reaction places additional strain on the big toe joint, accelerating bunion development. Therefore, the combination of altered foot mechanics and muscle imbalances associated with flat feet plays a significant role in the development and progression of bunions. https://www.youtube.com/shorts/pdyv58z1D2Y Preventing Bunions With Flat Feet First and foremost, it’s all about the shoes! Selecting footwear that fits properly with a wide toe box and adequate arch support is crucial. A spacious toe box prevents crowding of the toes, reducing pressure on the big toe joint and minimizing the risk of bunion formation. Adequate arch support helps maintain proper foot alignment, distributing weight evenly and alleviating stress on MTP joint. Avoiding high heels and narrow shoes is essential, as they can exacerbate foot misalignment and increase the likelihood of developing bunions. Incorporating custom orthotics can provide even more arch support if you have flat feet. These orthotics help correct overpronation—which we know now is a common issue—by stabilizing the foot's movement during the gait cycle and keeping it in neutral alignment. By improving foot alignment, orthotics reduce undue pressure on the big toe joint, reducing your risk of bunion development. Lastly, Engaging in specific exercises can strengthen the muscles supporting the foot arch, enhancing stability and function. These exercises should aim to: Strengthen Foot Muscles: Targeting the intrinsic and extrinsic muscles of the foot to provide better support for the arch and improve overall foot stability. Improve Flexibility: Enhancing the range of motion in the toes, feet, and ankles to prevent stiffness and reduce strain on the MTP joint. Enhance Balance and Coordination: Developing proprioception to ensure proper foot placement and gait mechanics, thereby reducing the risk of misalignment. Regular practice of these exercises can improve foot biomechanics, reduce overpronation, and subsequently lower the risk of bunions. See below for an example of a great flat foot exercise. https://www.youtube.com/shorts/whJ3TZAOn00 Foot Clinic Bunion Care If you already struggle with bunions and foot pain, don’t worry; there are plenty of options available to you. Bunions cannot be reversed after they form, but they can be managed with guided care from a podiatrist or chiropodist. The goal is to avoid invasive surgical intervention while still preventing bunions from impacting your daily life as much as possible. Most of these bunion treatment options are available at our downtown Toronto foot clinic: Footwear Modification. Wearing shoes with a wide toe box and avoiding high heels can help reduce pressure on the bunion. Orthopedic shoes designed to accommodate bunions provide additional support and comfort. Anti-inflammatory Medication. Over-the-counter NSAIDs, such as ibuprofen, can help reduce inflammation and alleviate pain associated with bunions. Bunion Splints and Aligners. Devices like bunion splints and toe spacers can help realign the big toe and reduce discomfort. They can provide symptomatic relief, and you can try a more rigid device if your bunion is severe. Therapeutic Taping. Applying tape to the foot can help maintain proper alignment and reduce strain on the bunion, providing temporary relief from pain and inflammation. Shoe Stretching. Professional shoe stretching can create additional space in the shoe, reducing pressure on the bunion without altering the overall size of the footwear. Supportive Insoles or Custom Orthotics. Custom orthotics can provide support to the arches and correct faulty biomechanics. This can potentially slow the progression of bunions by reducing pressure on the first MTP joint. Bunion Exercises. Strengthening foot muscles through specific exercises can improve joint stability and decrease bunion-related pain. Try these 5 simple exercises for bunions. Shockwave Therapy: This non-invasive treatment can address tight muscles and soft tissue injuries associated with bunions. This can potentially reduce pain and improve function. Implementing these non-surgical interventions can significantly alleviate discomfort and slow the progression of bunions, enhancing overall foot health and quality of life. https://www.youtube.com/shorts/8g43ZWreZ1g

March 6, 2025

Palmoplantar Keratoderma: What is it?

Figuratively speaking, it’s a good thing to have “thick skin,” right? But if you have palmoplantar keratoderma, it’s a different story. This condition, sometimes shortened to PPK, refers to a group of foot skin disorders characterized by thick, rough, and yellowed skin on the hand palms and feet soles. These conditions can be either inherited or acquired. In today’s article, we’ll explore the symptoms, causes, and, most importantly, the treatment options available. This type of skin thickening may warrant a trip to a foot clinic and the expertise of a foot care professional, such as a Chiropodist or Podiatrist. However, successful treatment may depend on the underlying cause of the skin thickening. What is Palmoplantar Keratoderma? This condition combines two scientific terms: palmoplantar, which specifically refers to the skin on the soles of the feet and the palms of the hands, and keratoderma, a term for epidermis (skin) thickening. In less common cases, transgradient keratoderma can affect the top of the hands and feet. The feet are usually more severely affected than the hands. Palmoplantar keratoderma (PPK) causes thickened skin on the palms and soles due to an overproduction of keratin, the protein that forms the outer layer of the skin. Normally, keratin helps protect the skin from friction, pressure, and environmental damage. However, in PPK, something disrupts the balance of keratin production and shedding, leading to excessive buildup. This happens because of genetic mutations or external factors that affect how skin cells grow and mature. Inherited forms of PPK often involve mutations in genes that control keratin formation or the connections between skin cells. These mutations make the skin cells more resistant to breaking down, so they pile up instead of naturally shedding. Since the palms and soles experience the most pressure and friction in daily life, they are especially prone to this excessive keratin buildup. Over time, the thickened skin can cause pain or become hard and cracked, depending on the severity of the condition. Some types can also cause blisters to form. Types of Palmoplantar Keratoderma and Associated Symptoms https://www.youtube.com/shorts/-iNFLGednYY Genetic (hereditary) keratoderma is usually divided into three main categories: diffuse, affecting the entire hand palm and foot sole; focal, where thickening is limited to pressure points; and punctate, which appears as small, hard lesions. Some genetic PPKs - particularly diffuse - are syndromic, meaning they are associated with other health conditions and additional symptoms, ranging from hearing loss to nail abnormalities to internal organ damage. Acquired PPK, on the other hand, is always syndromic and develops later in life due to external factors such as infections, inflammatory diseases, or underlying systemic conditions like internal malignancies. Acquired forms may be easier to treat since you and your healthcare team can address the underlying cause. Acquired PPK is also more common than genetic, since there are more causes and risk factors associated with it. Most types of PPK cause varying degrees of thick skin, potential foot odor (as a result of sweat combined with thick skin) and yellow/discoloured skin. Genetic PPK Types and Symptoms Diffuse PPK This form presents with even thickened skin on the palms and soles, often with a red border at the edges. Symptoms typically appear in early childhood and may include excessive sweating (hyperhidrosis). The thickening is usually confined to the palms and soles, without extending to the tops of the hands or feet. Focal PPK This type is characterized by linear (striate) thickened areas on the palms and soles, often following the lines of skin tension. It is typically caused by mutations in genes encoding desmosomal proteins, which are crucial for cell adhesion. A specific type of focal PPK called Pachyonychia Congenita is a rare genetic disorder that can also cause thick toenails. Punctate PPK This form is characterized by multiple small, hard, corn-like lesions scattered on the palms and soles. It is associated with mutations in genes that play a role in skin cell function. Acquired PPK Types and Symptoms PPK from Infections (syphilis, etc) Rough, scaly and yellow thickening on the palms and soles. May come with a rash or other symptoms affecting the whole body. Clears up when the infection is treated. PPK from Inflammatory Skin Conditions (psoriasis, eczema) Thickened, inflamed skin with redness and scaling. Can extend beyond just the palms and soles. Often improves with medicated creams or treatments that calm the immune system. PPK Linked to Other Health Conditions (cancer, hormone disorders) Yellow thickening of the palms and soles that appears suddenly in adulthood. Can sometimes signal an underlying health issue, like cancer. Needs further medical evaluation to check for possible internal diseases. What is the Difference Between Palmoplantar Keratoderma and Calluses? PPK is not the only cause of skin thickening on the feet and hands. In fact, it is more rare than another common culprit: calluses. But how do you know which condition you have? Calluses are localized areas of thickened skin that develop as a protective response to repeated friction or pressure. Commonly found on individuals who are physically active or spend long hours wearing ill-fitting shoes, they are much less severe than PPK. PPK tends to be thicker and more noticeable, alarming and unsightly than calluses, often covering a larger, symmetrical area on the palms and soles. It can appear hard and more yellow, or red and flaky. In some PPK cases, you may observe a red band at the edges of the thickened skin. Calluses can have a more mild appearance (but not always; they can sometimes be thick and painful!), with some people not even realizing they have them. Does that mean that PPK is the same as having excessive calluses? Not exactly. Calluses are only caused by friction and pressure----whereas PPK always has a driving force behind it, whether it's a genetic mutation or the result of an illness. https://www.youtube.com/shorts/yBACD8bUim0 Palmoplantar Keratoderma Treatment: Can a Chiropodist or Podiatrist Help? While there is no outright cure for certain forms of PPK, Chiropodists and Podiatrists can help manage symptoms, reduce discomfort, and improve mobility. This typically involves regular debridement (carefully removing excess skin), possibly prescribing medicinal products, and offering footwear advice to minimize friction and pressure. The latter may also include prescribing custom orthotics to properly distribute pressure on the bottom of the feet, especially if the thickened skin is impacting daily life. Scheduling an initial assessment is a good start! Naturally, since PPK can be linked to an underlying condition, more comprehensive care may be needed. A Chiropodist or Podiatrist might become a part of a broader team of healthcare professionals that can help you, including a dermatologist, your family doctor or other specialists trained to tackle the root cause. You may need advanced treatments such as topical retinoids, corticosteroids, or even laser therapy in some cases. https://www.youtube.com/shorts/sBIdll7qylQ

February 27, 2025

The Connection Between High Arches and Back Pain

Dealing with high arches and back pain can be a challenging combination, as the two are more connected than they seem. Understanding how high arches contribute to back pain is key to finding effective treatments and preventing further issues. Whether you’re dealing with foot pain, back pain, or posture problems, addressing high arches can significantly improve overall comfort and protect the rest of your body—especially your back. What are High Arches? https://www.youtube.com/shorts/osC-UmBtgNk High arches (or cavus foot or pes cavus) is a condition where the foot has an abnormally pronounced arch (as opposed to a flat foot or a normal arch). Having high arches can be due to simple genetics, inheriting structural abnormalities in the foot from your parents. They can also be caused by several neuromuscular disorders, which are conditions (ranging from mild to severe) that cause dysfunction or muscle weakness and leave certain muscles inactive. High arches generally develop during or after childhood when the flat feet most children have start to take shape and the foot arch forms. In some cases, idiopathic pes cavus occurs without a known cause (like genetics or neuromuscular disorders), and is just a case of simple variations in bone and ligament structure. A pronounced foot arch is usually quite discrete, aesthetically, and isn’t a serious condition. However, high arches are a common cause of foot pain and discomfort. High arches put extra pressure on the heel and ball of the foot, affecting normal pressure distribution and making it harder to absorb shock properly. This can lead to heel pain (plantar fasciitis— which is also commonly linked to flat feet feet), arch pain, and more, as the muscles and ligaments supporting the foot work overtime to stabilize each step, leading to inflammation or strain. High arches often cause the foot to roll outward, a motion known as supination. This can place extra stress on the ankles and knees, further disrupting alignment and increasing the risk of injuries like sprains and shin splints. It’s important to schedule an assessment with a foot specialist, like a podiatrist or chiropodist, if having high arches affects your daily life. The Connection Between High Arches and Back Pain https://www.youtube.com/shorts/7m3SQ5dXaeg A pronounced arch can also lead to back pain. But how do high arches affect the back when the two areas seem relatively far apart? The answer lies in how the body stays balanced. Many foot problems, not just high arches, often cause back pain—along with knee, leg, and ankle discomfort—because the feet serve as the body's foundation (carrying your weight) and closest connection to the ground. When that foundation is misaligned and overworked, the entire body has to compensate, leading to strain in other areas. Simply put, everything is connected, and the feet play a crucial role in maintaining functionality throughout our body’s kinetic connection! When it comes to the back, pain and poor posture often coexist. As we know, when the arches are too high, they can throw off the body's natural alignment, affecting the way you stand and walk. Uneven weight distribution forces the lower body to compensate, which can lead to foot pain and posture issues over time. The strain on the feet may cause the ankles to supinate, shifting stress to the knees and hips. This misalignment can travel up the spine, making it harder to maintain proper posture and increasing the risk of chronic discomfort. Without proper shock absorption, the impact of each step travels up through the joints, leading to tension in the lower back and shoulders. Over time, these small imbalances can create lasting posture problems, making everyday movements more difficult. Treating High Arches and High Arch-Related Back Pain When you treat high arches, you’re also preventing any potential back pain that may occur further down the road. But if you already struggle with high-arch related back pain, you can still focus on treatment methods that simultaneously target both issues. Video Gait Analysis https://www.youtube.com/shorts/Rhuga6vLdc0 This is when a Chiropodist or Podiatrist assesses your walking patterns (also known as your gait) using video gait analysis equipment. It can give foot care professionals insight into the potential damage your high arches could cause, so they can recommend preventative treatments. Custom Orthotics and Insoles A Podiatrist or Chiropodist can prescribe custom orthotics that you can wear inside your shoes. They will provide much-needed arch support, distribute weight evenly, and reduce strain on the feet and spine. Another option is over-the-counter Superfeet insoles, with the Superfeet Green: All Purpose High Arch being a good choice to ask your foot specialist about. Supportive Footwear Look for shoes with good arch support, cushioning, and shock absorption to minimize impact on joints. People with high arches should wear shoes with flexible midsoles or rocker soles to improve movement and reduce strain. Cushioning running shoes with shock absorption help counteract supination, ensuring even pressure distribution and healthy biomechanics. Avoid high heels, rigid soles, and unsupportive flats, as they can increase discomfort. Read more about the link between footwear and back pain. Stretching and Strengthening Exercises https://www.youtube.com/shorts/-EeyHTdkrEs Targeting the feet, calves, and lower back can improve flexibility and stability, reducing pain. Some of the best include towel stretches (where you place a towel under your foot arch and pull towards you), seated toe pulls (pulling the top of your foot towards you - see above!), ankle circles and massage ball rolls (rolling your foot arch on a therapeutic massage ball). You can read more about them, including how to perform them, here. You can also try clamshells on an exercise mat with your ankles together (this will also help soothe hip pain. See below for a demonstration! https://www.youtube.com/shorts/ZODK0Q4zOws

February 6, 2025

Why High-Stack Running Shoes are So Popular

The HOKA trend is the rise in popularity of HOKA's high-stack running shoes, or running shoes with extra cushioning, extra height, a high heel stack and a rocker sole. They aren’t the first popular running shoes trend, and they certainly won’t be the last. Although people exclusively associate this type of trendy running footwear with HOKA, many other brands like ASICS and Saucony make footwear with the same high-stack shoe technology. Today, we’re diving into why these shoes offer more than just style—they come with real benefits. But they’re not for everyone, so we’ll also cover who should steer clear of this particular design. https://www.youtube.com/shorts/ySn158c143c What are High-Stack Running Shoes? High-stack running shoes, often called “super cushioned” or even “chunky,” by those who don’t know the terminology. They have transformed modern footwear design for many high-quality brands. Often attributed to HOKA for “starting the craze," these shoes feature thick midsoles packed with advanced cushioning foam technologies that enhance energy return, provide sufficient shock absorption, and improve comfort over long distances. Despite their benefits, high-stack shoes aren’t without controversy. Some runners prefer lower-profile shoes for better ground feel and stability, while others find high-stacks beneficial for injury prevention and endurance. Their chunky aesthetic has also sparked mixed opinions—some love the bold look and the added height without having to wear a true high heel while others see them as clunky. High-Stack Shoe Technology The defining feature of high-stack shoes is their thick midsole, which can measure over 40mm in some models. These midsoles use lightweight, resilient foams such as Pebax or EVA blends that provide exceptional cushioning while maintaining responsiveness. The goal is to reduce muscle fatigue by absorbing more impact, allowing runners to maintain performance with less strain on joints and soft tissues. Another key factor in their performance is the rocker geometry, rocker bottom shoe or rocker sole—curved soles designed to promote a smooth heel-to-toe transition. This feature helps conserve energy, particularly during long runs, by reducing the work done by the calves and ankles. ASICS Gel Nimbus 27 The Benefits of High Stack Shoes High-stack running shoes offer several benefits for foot health, especially for individuals dealing with arthritis, diabetes, and metatarsalgia. Here's a breakdown of their advantages: Enhanced Cushioning: High-stack running shoes feature extra cushioning, which absorbs shock and reduces impact on the feet during movement. This is particularly beneficial for people with conditions like arthritis, where joints are sensitive to pressure and movement. Pressure Redistribution: The additional cushioning and rocker sole work together to redistribute pressure across the foot. In the case of diabetes or metatarsalgia, this can help alleviate excess pressure on specific areas of the foot, such as the forefoot or metatarsal heads. For those with diabetes, reducing pressure can help prevent the skin damage that leads to ulceration, as it lowers the risk of tissue damage and enhances comfort. (However, people with diabetes and balance issues may wish to avoid rocker soles - more on that later). Joint Protection: The rocker sole limits the motion of foot joints. This helps manage conditions like osteoarthritis and hallux limitus (big toe arthritis). By restricting unnecessary movements, it prevents excessive strain on the joints, protecting them from further damage. This is especially useful for the big toe joint, where excessive motion can lead to increased pain and discomfort. It's also highly beneficial for people with high arches. People with high arches tend to experience joint rigidity (particularly hallux limitus) and lack of shock absorption. The rocker sole offsets the restricted mobility. Improved Biomechanics: The curved design of the rocker sole encourages a smoother, more efficient gait. The shape propels the foot forward with each step, facilitating a natural walking motion and reducing strain on the joints. This is particularly beneficial for those with ankle, midfoot, or big toe arthritis, as it helps maintain normal walking patterns without overloading the affected areas. Pain Reduction: Rocker soles are especially effective in reducing pain associated with conditions like hallux limitus and metatarsalgia. By minimizing motion at the big toe joint and redistributing pressure under the ball of the foot, these shoes can significantly reduce the discomfort felt during daily activities like walking or standing. https://www.youtube.com/shorts/qByZ0GRFoaQ When to Avoid High Stack Shoes Here are some individuals who might want to avoid them or consult a foot care professional, like a Chiropodist or a Podiatrist, before wearing them: People with Balance Issues The rocker sole on high-stack shoes can make them less stable for individuals who struggle with balance or proprioception (awareness of body position). Those at a high risk of falls, such as elderly individuals or those with severe neuropathy, may find that the rocker sole from stacked heels throws off their balance. People with Diabetes Complications from diabetic neuropathy can lead to balance issues. Therefore, while the cushioning of a stacked heel is great for addressing joint issues, the "rolling" effect of the rocker sole is not suitable for people with diabetes. Individuals with Ankle Instability The increased midsole height and curved design can reduce ground feel and make it easier to roll an ankle, especially on uneven surfaces. People prone to ankle sprains or with a history of ankle instability might be better suited to lower-profile shoes with more lateral stability, or stability shoes with posting in the midsole (like the ASICS Gel-Kayano), which is constructed to cradle the foot and control ankle movement. In shoes like the ASICS Gel-Kayano, even though there is a stacked heel, the foot actually sits below the sole to provide stability. https://www.youtube.com/shorts/osC-UmBtgNk

January 9, 2025

4 Tips For Living With High Arches

Living with high arches can be a challenge, but if you pay attention to your foot health, you can manage them effectively. Let’s explore what high arches are, their impact, and our top 4 tips for living with high arches. What Are High Arches? https://www.youtube.com/shorts/13rmyA18ZzY High arches (pes cavus) is a condition where one has - you guessed it - abnormally high foot arches. They are essentially the opposite of flat feet, which are characterized by having a minimal or non-existent arch. High arches may be hereditary or caused by neurological disorders such as Charcot-Marie-Tooth disease. From a biomechanical perspective, the raised arch reduces the surface area in contact with the ground, which can result in an uneven distribution of weight across the foot. High arches often place excessive pressure on the ball and heel of the foot, leading to discomfort, instability, potential injuries and chronic foot conditions. High arches also impairs shock absorption, which causes progressive wear-and-tear on the joints over time. Side effects of high arches include foot pain, issues like calluses and hammertoes, and an increased risk of ankle sprains. Individuals can also develop conditions like plantar fasciitis (this can also frequently occur in people with flat feet), or Achilles tendonitis due to the strain placed on the muscles and ligaments. The lack of shock absorption can also reverberate up the body and lead to joint disorders like arthritis. High arches are associated with supination, also called underpronation, a condition where the foot rolls outward during movement. This gait pattern places additional stress on the outer edges of the foot and ankle, leading to instability and overuse injuries. Consequently, individuals with high arches should pay close attention to their walking or running patterns to prevent long-term complications. High arches can also lead to changes in posture and gait. This, combined with the lack of shock absorption, may result in secondary issues such as knee, hip, or back pain over time. Tips for Living with High Arches https://www.youtube.com/shorts/2et0ZUSx4OM Living with high arches requires thoughtful adjustments to your daily routine and habits. Here are some ways to keep your feet comfortable and supported: 1. Choose the Right Footwear Proper footwear is essential for managing high arches. Opt for shoes with ample shock absorption, arch support and cushioning. Shoes with flexible midsoles or rocker soles can also be very helpful: People with high arches tend to have rigidity in the toes and ankles due to joint wear-and-tear, which means the toes and ankles do not flex as much as it should during the gait cycle. A flexible midsole and rocker sole counteracts this and make movement easier. Likewise, people with high arches should avoid high heels, rigid soles, and unsupportive flats, which can exacerbate discomfort. Due to supination, people should look for cushioning running shoes. These provide balanced cushioning and plenty of shock absorption and flexibility to support the foot’s natural motion and healthy biomechanics. This design helps distribute pressure evenly, enhances comfort, and reduces the risk of injury. 2. Wear Custom Orthotics Custom orthotics are a valuable tool for redistributing pressure evenly across the foot. You can work with a specialist, like a podiatrist or chiropodist, at a foot clinic to create orthotics tailored to your specific needs. Scientifically, custom orthotics help correct abnormal biomechanics, such as excessive supination, by stabilizing the foot and encouraging a more neutral gait. They can also provide added cushioning to reduce the impact of your stride on your joints. Over time, this can alleviate pain, reduce fatigue, and prevent the development of secondary issues in the knees, hips, or lower back. 3. Maintain a High Arch Foot Care Routine Foot baths and massages can soothe foot pain, relax the muscles in your feet and boost blood circulation. Soak your feet in warm water with Epsom salts, or foot bath products from reputable companies like Gehwol, to alleviate tension. Gehwol products, such as their Herbal Foot Bath, are available to buy at our Toronto foot clinic, Feet First Clinic! Gently massage the arch, heel, and toes to improve circulation and relieve tightness. Read this article to learn how to give yourself a foot massage from home. 4. Try Stretching and Strengthening Exercises Foot stretches and exercises play a crucial role in managing high arches by improving flexibility, reducing muscle tightness, and promoting better blood circulation in the feet. High arches can lead to stiffness and imbalances in the tendons and muscles, increasing the risk of discomfort and injury. Over time, these stretches can support better alignment and strengthen the foot's ability to handle daily stress, making them an essential part of high arch foot care. Here are some simple routines you can try today! Toe Flex and Raise: While standing, plant your toes and lift your heels off the ground. Hold for 15-30 seconds and repeat 5 times. Seated Towel Stretch: Loop a towel around your foot and gently pull it toward you, holding for 15-30 seconds. Pen Pick-ups: Stay seated. Then, lay three pens, or similarly shaped objects, in front of you–spaced apart evenly. Using your toes, pick up each pen and place it in a bowl. Seated Toe Pulls: Sit on a chair and cross one ankle over the opposite knee. Grab the top of your foot and gently pull it toward your body until you feel a stretch on the top of your foot. Hold for 15-30 seconds and repeat 2-3 times per foot. https://www.youtube.com/shorts/-EeyHTdkrEs Additional High Arch Pain Relief Tips More practical approaches for high arch pain relief include: Ice Therapy: Apply an ice pack to sore areas for 15-20 minutes to reduce inflammation and soothe discomfort. If your feet are particularly painful, take this one step further by practicing the RICE method (Rest, Ice, Compression and Elevation). Supportive Inserts: Use over-the-counter insoles with firm arch support. A good choice for high arches is the Superfeet Green or the Superfeet Run Cushion High Arch insoles. However, talk to a podiatrist or chiropodist about if you need more customized support from orthotics. Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) may help manage pain. Seek Professional Help: Visit a podiatrist or chiropodist for a biomechanical assessment to determine how prominent your high arches are, how they are affecting your body, and any contributing biomechanical factors. These foot specialists can also fit you for custom orthotics, provide shoe recommendations and curate a full treatment plan. When to See a Specialist For High Arches If high arches are causing persistent discomfort or limiting your mobility, it’s essential to seek professional advice. As we mentioned, visiting a foot clinic ensures access to personalized treatment plans. Consulting a foot specialist is especially important if you notice: Increased frequency of ankle instability or sprains. Development of deformities like hammertoes, claw toes, or bunions. Chronic pain that makes simple activities like walking increasingly difficult. A foot specialist can recommend the appropriate treatments, depending on the severity of your condition. They may also suggest physical therapy to improve balance, coordination, and overall foot function. Regular check-ups and assessments with a podiatrist or chiropodist can prevent seemingly minor issues from becoming major concerns. Don’t hesitate to seek their expertise! https://www.youtube.com/shorts/XZUfVhny5pY

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Metatarsalgia: Treating your forefoot pain right

In general, to treat your forefoot pain, you must:

Reduce inflammation

Change your footwear and get custom made orthotics

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