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Sports Medicine

Balls of feet>in pain

07/25/2000

Question:

I have an extremely painful area on the balls of my feet, I try to exercise, walk/run 2 or 3 miles daily. My feet become painful, just like a sock has bunched up in my shoe, I went to the podiatrist and he thought I had something called..siesmoldilitis (I know that isn`t spelled right) he put little pads in my shoes, and this seemed to help for a while, but now there hurting again, what is this? and can I do anything else to eleviate the pain? The pain usually occurs also upon getting out of bed and after sitting, sometimes like an electrical zap to that same area, then after I walk/run for a while they just become painful. thanks for any info. p.s., I also went to an athletic store and got a good pair of cushioned running shoes.....they still are painful...thanks

Answer:

There are many conditions associated with running that can cause pain in the balls of the feet.

To start off, "sesamoiditis" is a condition where the sesamoid bones in the foot become inflammed, and in some cases can develop a stress fracture or a true through-and-through fracture. The sesamoid bones are small pea-sized bones within the tendons of the big toe on the ball of the foot. Constant impact (such as running) can lead to this condition. Usually, the athlete will complain of pain the the ball of the foot, usually under the ball of the foot next to the big toe. Walking can be painful, and as the person runs, it usually becomes more and more painful.

The pads you refer to could be one of two kinds. A relief pad is a small donut-shaped pad placed directly on the ball of the foot to take pressure off of the sesamoid bones. The other type of pad commonly used is called a metatarsal pad, which has a sticky side that you put into your shoe. This elevates the heads of the metatarsals (i.e., the "balls" of your feet), and takes pressure off.

The other thing you mention is a feeling of an electrical zap - this is important because it may represent what is called a "neuroma" which is completely different from sesamoiditis. Sometimes a benign growth of nerve cells forms between the heads of the metatarsals (balls of feet) and gets pinched together and gives similar symptoms. Treatment for this is entirely different than sesamoiditis.

The other condition that comes to mind is something called "metatarsalgia", which is a poorly defined condition that refers to pain in the balls of the feet. It is thought that repetitive impact to that area can cause small microfractures and inflammation that cause pain.

In any case, if the pads don`t work, go back to see your doctor. An x-ray and/or bone scan and injection can usually identify the true problem.

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Response by:

Chris M Amann, MD Chris M Amann, MD
Clinical Faculty, Team Physician
College of Medicine
The Ohio State University