Pain under the ball of the foot (Metatarsalgia) is a common complaint with women wearing high-heeled shoes, as well as men wearing work boots or other hard shoes while standing for long periods.
Ball of Foot Pain occurs frequently when wearing high-heeled shoes, which cause our weight to be unevenly distributed across our feet, putting undue pressure on the metatarsals (forefoot bones).
Footminders Catwalk Orthotics were especially designed to support the foot arches in just the right places to relieve the excess pressure on the forefoot caused by wearing high-heeled shoes.
Ball of Foot pain can also occur when wearing normal footwear, especially during long walks or standing for longer periods of time. Metatarsalgia is often described as a burning sensation in the ball of the foot, often combined with excess callous forming. Recommended orthotics for Ball of Foot pain: Footminders Catwalk insoles for ladies fashion shoes or Footminders Comfort insoles for other footwear.
For high heel wearers there’s now a great new product on the market called Footminders Catwalk.
This means that your bodyweight is distributed more evenly over the entire foot, instead of just on the forefoot.
Just wanted to let you know that I’m so excited about my new orthotics from Footminders. A few years ago I decided to increase my weekly running mileage from about 4-5 miles to 6-7 miles with my normal New Balance shoes for wide feet (4E). I want to extend to you my heartfelt thanks for eliminating the pain I was having in my left heel. I am an avid tennis player and have suffered from heel pain in my right foot for more than 4 months.
Stress fractures are ridiculously common among runners, but this post will specifically address the apparent rash of metatarsal stress fractures afflicting minimalist and VFF runners, including myself.
The majority of stress fractures affecting minimalist runners are not impact-related, but rather result from overloading weak metatarsals with increased toe push-off. Metatarsals are most susceptible to injury because they’ve been immobilized and weakened by conventional shoes.
Skin protection offered by VFFs and minimal shoes likely increases the risk of injury, friction on bare toes would have limited activity before the bones could have been hurt.
Proximal stress fracture of the second metatarsal after running much faster than usual in VFFs. Bob at Downtown runner (51 years old)Second metatarsal stress fracture in VFFs during a short race while running at a personal record pace. Third metatarsal stress fracture after sprinting the last half mile of a short run in VFFs.
If you’re a near-barefoot, minimalist or VFF runner and have suffered a stress fracture, please email me or leave a note in the comments. I believe I now have a stress fracture too after 5 weeks of running in a pair of Vibram 5 finger shoes. This happened to me about 5 months ago, it is winter so I haven’t run much in them, I am nervous to start up again. I have been running barefoot (unshod) and in minimalist shoes for upwards of 2 or more years now.
I have logged a lot of miles barefoot and in minimalist shoes and I have noticed a lot of change in my feet since then.
What I am trying to figure out is if there is a link between high arch due to barefoot running and metatarsal stress fractures.
I began minimalist running in July 2010, starting out with the Nike Free Run+ as my only shoe.
By this point, I had completely caught the minimalist bug and bought a pair of VFF Bikilas and was rotating them in once or twice a week with low mileage (2-3 miles max for the first month). As winter approached, I was becoming frustrated with the heel-toe drop in the Frees as I felt like I they were now adversely affecting my form. Last week, the weather became warmer and I decided to bring the Bikilas back into the rotation.
What part of your forefoot are you landing on and what happens next – are you allowing the heel to come down or holding it off the ground. The reason why it isn’t neccessery to push off strongly is simply that the actual horizontal forces of areodynamic drag are tiny compared to vertical force of gravity acting upon you, as little as 1% for jogging speeds, even for world class sprinters drag is still small compared to vertical forces.
I have no idea how much those shoes immobilize your midfoot, but you need to give the bone a chance to heal. I transitioned cold turkey from Brooks Green Silence to the Merrill Trail Glove 6 weeks ago.
After an somewhat fast 8 mile run last Friday on mostly asphalt (which was unusual) and continuing to grow my mileage during the six weeks, I took the following day off. While I tend to agree that I may not have been using proper barefoot running technique, I also believe the treadmill may have contributed to the problem.
My transition over a year ago was slow and methodical, it took away my shin splints, and allowed me to run pain free after a complete reconstructive knee surgery which has pained me for years. Add my fractured 2nd metatarsel to the list of injuries incurred in the 2-3 month, over 35 yrs range! Your animation assumes that the load of your body is being leveraged by the forefoot and the metatarsals.
Then again, without proper strengthening that may still be too much for the inexperienced barefoot runner such as myself. Joe’s theory makes complete sense because the muscle tissue does build faster than the bone.
Casey believes that impact forces are a not factor for most running injuries as the measured impact forces are actually relatively low, instead most are injuries caused by loads around mid stance and after when the loads are at their maximum. I love biking & swimming while I heal, but its so not the same as pounding the pavement!!!! I learned some good things from Chi Running and also learned that you were wrong about some things in Chi Running. The good:  Chi Running has the runners lift their feet and let gravity do the work of pulling us forward. Sounds like you are a perfect candidate for a Physical Therapist who treats running injuries.

I was fine after that run, but my next time out I only did 2.5 miles before experiencing a sudden stabbing pain over my second metatarsal. When i felt better I started running again, and the pain came back, not as intensely as the first time, but still pretty bad. When I got home I squatted down barefoot to unpack my suitcase, had all my weight on the balls of my feet for a minute or two. Podiatrist recommended that I not wear minimalist shoes that flex so strongly across the forefoot, since I have REALLY flexible wide feet (grew up basically barefoot, in Florida, almost never wore shoes) and he said the lack of support for my floppy feet was creating too much motion in the bones and stressing them. Hi Im a male 28 years old, seem to have bruised my second metatarsal, started running on vff for a month.
Pain in this area of the foot may also occur when wearing hard shoes without any cushioning inside, such as work boots. As a result, these bones drop, the surrounding ligaments weaken, and the entire forefoot structure collapses.
This type of ball-of-foot pain can be treated with a full-length orthotic such as podiatry-designed Footminders Comfort, which features a metatarsal raise to help alleviate the pressure and friction in the ball of the foot. The pain worsens when wearing high heels or tight fashion shoes for longer periods of time.
Footminders Catwalk Orthotic Insoles restore biomechanical balance by supporting the arch, as well as the metatarsal bones. Absolutely no arch, and pronation to the extent that I can only walk a few minutes without orthotic support before my lower legs begin to cramp and burn. One of our waiters told me about your website, so I ordered them on-line which I normally never do, buying on in the internet.
I ran 7 miles in one go without incident, but the next day I had serious pain in both my feet which lasted 2+ weeks.
I had been to my physician, he recommended cortisone injections which I didn’t like the idea much of.
I used gel heel pads, ice, pain killers etc but nothing proved really effective until I heard about your product from a friend. Through out my career I suffered many times of chronic plantar fasciitis, Footminders was the only product that got rid of the plantar fasciitis pain. These injuries arise several weeks or months after switching to natural running because the runner’s muscles strengthened faster than their bones.
Re-introducing midfoot flexibility after 35+ years may increase the risk of metatarsal stress fractures, but that increase is only because we’ve immobilized our feet for so long. I am training for a half marathon, and while I slowly increased my speed and distance from August to December, I really started to ramp things up after that.
In late September 2010 I started feeling the pain of a metatarsal stress fracture in one foot, at the time i had no clue what the pain was or what i did to cause it. I ran until mid January, 2011, when the other foot met the same fate… I was on a run and climbed up on a 5 foot retaining wall to get around a mud puddle in the path i was running on. Within two months, I had built up enough mileage in them to do the Chicago Half Marathon comfortably and without any injury. When running in them, I had the expected calf pain and some minor top of the foot pain that was easily addressed with regular ice foot baths. To prep for the Chicago winter (which was nasty this year), I bought a pair of zero-drop GoLite Amp Lites, which I used with YakTrax Pros in the heavy snow, as well as a pair of Terra Plana Vivobarefoot Evo IIs for cold weather, but light snow. On Saturday, April 9th, I went on an 8 mile run in the Bikilas (along a soft, asphalt path) and as I finished, I felt pain in my left foot. On a few of the first runs I ended up with blood blisters under the two toes that had the most wear in VFFs. Because walking on bare feet around my house or in the VFF cause a pain, though very small and no problem tolerating it.
No matter how perfect we think our form is, putting skin on the ground reveals all kinds of things we didn’t know we were doing. Gordon Pirie (ex world record at 1500m, 5000m and 20km) says to land on the outside edge of the forefoot and to let the heel come down to touch the ground to avoid strains.
Because the speed is controlled by the treadmill, I sometimes have to accelerate if I am falling behind. 52 yr old male, never been much of a runner, started running short and easy in VFF about 15 months ago, never more than a mile or two once or twice a week.
At midstance with maximal plantar contact (and maximal plantar pressure) the centre of pressure then starts moving anteriorly along the same path as the 2nd and 3rd metatarsals during the propulsive phase.
Just out having a good time in my Newton running shoes, then sudden pain, limped all the way back home. Did my first run on 10k under 40 min after aprrox 1 moth in the new shoes, so I have both been running faster and more often.
He recommended that I get shoes that only bend across the tip of the toe area, not further down the shoe. I was so thrilled to have found minimalist shoes, but now it seems that my feet can’t handle them unless I ramp up EXTREMELY slowly, maybe. The orthotics and stretching exercises seem to work very well for me and the pain has almost disappeared!
This happened running faster than a jog but not fast in vibram flows and also the newer bilkas. The same thing can and will happen in any minimalist shoe which allows natural foot motion. Also, this specific bad form would have been limited if barefoot because the skin under the toes would have been injured before the bones were hurt.
I figured out that the pain would subside when I stopped running and would gradually get worse the more, longer and days per week, that I ran. The old shoes that I have laying around were way too tight on the mid foot, I had to loosen the laces a considerable amount to have them fit comfortably.
After two months, I was comfortably running up to 8 miles in the Bikilas with no issues on a variety of terrain. The pain increased over the next 12 hours to the point where I could not put any pressure on it. However, reading your article has made me think it might make sense to actually go the other way and do some very basic, truly barefoot work to adjust my form so that I’m not pushing off of my left forefoot so much.

While my foot heals, I’ve been looking into ways to correct the asymmetrical running pattern that I appear to have. I have noticed acute pain on palpation on my 2nd metatarsal in my right foot after increasing mileage or running too fast.
About 8 weeks ago I switched over to Merrell Trail gloves and after a few weeks began to experience some top of foot pain on lateral edge so went and had an x-ray. I switched to running in huaraches as soon as the weather warmed this March (I live in northern Vermont). The centres of pressure are  dramatically different in mid foot strikers and heel strikers.
I thought it was because the design of the pair I had were tight across the instep but reading this article imples other things might be going on.
I started back in running in June after a break of several months for bad viral bronchitis. I told him that I suspected a stress fracture of my 2nd metatarsal and he agreed that this seemed like the most likely diagnosis.
The key reason for this problem is that when wearing high heels, most of our body weight is resting on the forefoot area. The ones I just received from your company are at least as good as those and so much less expensive.
I searched on the internet for orthotics and found these great orthotic insoles from Footminders. I am so impressed because I really didn’t have very high expectations and felt it might be a gamble to even try them. I’ve decided these are more risk than return and plan to sell or most likely throw them away. Minimalist shoes are wonderful, but they may protect your skin just enough that you end up hurting something else. I’ve now been in an air cast for the past five days, having been diagnosed with a stress fracture in my fourth metatarsal. Wondering if, as you suggest, losing the shoes may help to correct that as well (following Barefoot Ken’s advice, of course). The first time I realized that it may be a stress fracture I took 2 weeks off and then ran in regular shoes for three weeks (still mid-foot strike) and then I was pain free.
The low mileage I do is either indoor track or treadmill with a very occasional asphalt trail. I’d been running for the last 4 or 5 years mostly in minimalist shoes (Puma H Streets), including several marathons. You forgot to factor in that after you land, it is your upper leg (knees, thighs and hips) that leverages the bulk weight of your body forward NOT your foot. But, I would also say that many people with  minimalist shoes are also landing more on their forefoot (to cushion the shock of landing) which also adds stress to the metatarsils. So into a CAM boot for me, and I will be in one for the next 4-6 weeks to let it heal completely. A safe transition from traditional running shoes to minimal or barefoot should take 6-12 months. In November after a half marathon race i could barely walk, so I decided to take off several weeks and see if my foot would heal.
The next day everything seemed fine no pain was apparent so i went for a run, it ended up being a fast run at 6:30 pace or so, and by the end i had to limp in.
It seems plausible that the steeper angle of your metatarsal bones cause by rising arches puts more stress on the bone than before. I would almost be willing to theorize that this is the real culprit, because it’s a matter of impact upon landing and therefore has a multiple factor of body weight backing up the force to the forefoot. Don.t blame the shoes though, I was too happy about the good result and pushed my body to hard without listening. Got back up to 3 miles and was running that consistently, then one night I had a huge burst of energy and fitness and did 4.5 miles at my best speed ever. It did, after at least a month off of no running all the pain disappeared and I started back running gradually and easy. The rise in arch might happen too fast, not allowing bone density to increase to handle the new stress resulting in fracture. Two weeks ago, a couple days after doing a longer-than-normal run, I developed a strong pain in the top of my right foot, over the second metatarsal.
Went camping and I was on my feet a lot in Crocs (bendy shoes) around the campsite, squatting down a lot, etc.
Actually suffered stress fracture while running in reg sneakers but I think the damage was already in place. I have been doing boot camp 3x a week in them and running short distances on the off days with one long run (7-11 miles) per week.
I stopped running, limped when walking for 2 or 3 days, and am now using a rowing machine while things heal up. 4th time, the pain was still there, though went away after 5min of running, but then showed up after the run. On Aug 20 I ran 11 miles in Chicago and then later that day wore 5 inch heels and danced the night away. Unless you learn to reduce your impact with the ground at the end of every stride, you’ll always be at risk for injury. The VFF however automatically caused me to land on the middle of my foot, I’d say even significantly so. Like, I’m thinking that just walking around in the house in bare feet might be a good gentle start.

Doctor sole slippers
Custom made shoe inserts orthotics
Feet are constantly aching

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