Metatarsal pads are specialized shoe inserts designed to alleviate pressure and discomfort in the forefoot, commonly referred to as the ball of the foot. These pads function by supporting the transverse arch, which runs widthwise across the foot just behind the toes. This support helps to redistribute weight away from the sensitive metatarsal heads. Correct placement is necessary for the device to effectively treat conditions such as metatarsalgia, Morton’s neuroma, and capsulitis. If positioned incorrectly, the pad can fail to provide the intended mechanical support, potentially worsening foot pain or creating new pressure points.
Choosing the Proper Pad Type
Before application, consider the variety of materials and shapes available, as these factors influence comfort and effectiveness.
Materials
Common materials include felt, foam, and gel, each offering a different level of firmness and durability. Felt pads, made from compressed wool, are the most firm and durable option, frequently recommended when maximum support is desired. Softer foam and gel pads provide resilient cushioning and shock absorption, making them a suitable choice for users seeking greater comfort or those with sensitive skin.
Shapes and Attachment
The shape of the pad, such as teardrop, oval, or met dome, may be selected based on the specific foot condition or the shoe type. For instance, a wider pad may be used to support all five metatarsal heads. A narrower pad might be chosen to target the space between the third and fourth metatarsals, which is often necessary when treating Morton’s neuroma. Most pads are designed to be secured either directly to the foot or to the shoe’s insole, typically using adhesive backing.
Step-by-Step Guide to Correct Placement
Proper placement requires locating the precise anatomical region the pad is intended to support, which is the transverse arch just behind the bony metatarsal heads. To find this area, a user should first identify the ball of the foot, the padded region immediately below the toes. The metatarsal heads are the bony prominences within this area that bear the majority of the weight during walking.
Locating the Position
The fundamental rule for placement is that the pad must sit proximal to the metatarsal heads, meaning it should be placed just behind them, toward the heel. Placing the pad directly underneath the metatarsal heads, or on the sore spot, is a common mistake that can increase pressure and cause discomfort, effectively acting like a small stone in the shoe. The pad’s purpose is to lift and support the metatarsal arch slightly, which in turn encourages the metatarsal heads to drop and relieve pressure.
Application Method
To ensure accuracy, remove the shoe’s insole or orthotic and use it as a template for application. A practical method involves placing the insole on a flat surface and positioning the pad loosely in the target area. The highest point of the pad should align with the center of the foot, typically underneath the second, third, and fourth metatarsal shafts. The target zone for the metatarsal pad is positioned just before the area where the ball of the foot would rest.
Testing the Fit
Once the pad is tentatively placed, the user should put the insole back into the shoe and stand, feeling for a gentle lift in the arch area. The pad should be felt as a supportive bump, not a painful point of pressure. The toes should also feel slightly less stressed. If the placement feels correct while standing, the user can then walk a few steps to confirm the pad supports the foot through the gait cycle. Only after this test should the adhesive backing be fully secured, ensuring the pad is firmly attached to the insole without shifting.
Troubleshooting Misplaced Pads
When a metatarsal pad causes increased pain or feels like a foreign object, it is positioned incorrectly and requires adjustment. One common error is placing the pad too far forward, resulting in the pad sitting directly under the metatarsal heads instead of behind them. This misplacement adds compression to the irritated area, producing a sensation similar to walking on a pebble.
Conversely, if the pad is positioned too far back toward the heel, it offers little therapeutic effect because it is not engaging the transverse arch. If the pad is ineffective or uncomfortable, a minor adjustment of about one-quarter inch forward or backward is sufficient to find the optimal spot. If several adjustments fail to achieve comfort or pain reduction, it may indicate that a different pad size or firmness is needed, or that a consultation with a podiatrist is warranted.