Your feet serve as the sturdy foundation of your body, equipped with 26 bones, 33 joints, and more than 100 muscles, tendons, and ligaments. Remarkably resilient and naturally strong, they are built to withstand various forms of stress and recover from pain and injuries. However, when you experience discomfort in the ball of your foot — also known as metatarsalgia — it can disrupt your daily activities in numerous ways.

Metatarsalgia is often related to engaging in activities that involve running or jumping. But this doesn't mean that being active is bad for your feet. It just means that if you do more than your body — and feet — are prepared for, it can contribute to pain. “The balls of your feet are resilient to the different types of activities you expose yourself to,” explains Mijo Cotic, PT, DPT, a physical therapist at Hinge Health. “But there are times when you may need to modify or scale back on certain activities.”

Here, learn more about what causes ball of foot pain and how to prevent and manage it — especially with exercises from our Hinge Health physical therapists.

Understanding Foot Anatomy

Amazingly, a quarter of your body’s bones are in your feet. The largest is the calcaneus, or heel bone, which is directly below your ankle. On top of your calcaneus is the talus, which is part of your ankle joint. Five tarsal bones form the arch, and five thin metatarsals make up part of your forefoot (front part of foot). 

The ball of your foot is made up of your metatarsal heads, explains Dr. Cotic. “Each of the five metatarsals leads to a toe,” he says. These bones, and the muscles and ligaments around them, need to be stable, flexible, and strong to keep you upright and moving. Normally, they do their job very well. But when something is off, it can contribute to ball of foot pain.

Symptoms of Ball of Foot Pain

Symptoms of ball of foot pain include:

• Sharp or aching pain in the ball of your foot

• Pain that worsens with movement, including walking, running, or flexing your feet

• Numbness or tingling that extends from the ball of your foot into your toes

• A feeling like you have a pebble in your shoe

Ball of Foot Pain: A Hinge Health Perspective

When you have ball of foot pain, you may be tempted to stop all activity entirely. But movement can help facilitate healing. “You don’t want to get rid of activity. You can still be active without irritating anything,” points out Dr. Cotic. “You may just want to modify what or how much you’re doing.” This may mean that you need to temporarily switch to no-impact or low-impact activity while your body heals. This could include swimming, cycling, the elliptical, and targeted stretching and strengthening exercises (more on this below). 

What Causes Ball of Foot Pain?

Ball of foot pain can happen for many reasons. Sometimes it’s due to things you can control, like the types of shoes you wear. Other times it’s due to factors you don’t have control over, like your basic foot anatomy. Most of the time, it’s a mixture of both. Here are some causes of ball of foot pain: 

• Your foot shape. A common cause of ball of foot pain is a high arch, which puts more pressure on your metatarsal bones, says Dr. Cotic. Some people also have a second toe that’s longer than their big toe. This puts more weight on your second metatarsal, which can then contribute to ball of foot pain.

• Ramping up activity too quickly. “We see metatarsalgia often in distance runners who ramp up their workouts too quickly, because of the repetitive stress on the front of the foot,” explains Dr. Cotic. Distance running — or any type of running — isn’t bad, though. Any activity that causes you to go beyond your movement sweet spot can be a factor in ball of foot pain. This usually improves once you modify your activity a bit.

• Shoes that are too tight. These can contribute to hammertoe, which is when your second, third, or fourth toe bends down so that it looks like a hammer. Shoes that don’t fit well can also contribute to bunions — bumps at your big toe’s base that can contribute to ball of foot pain.

• Plantar fasciitis. This condition, which involves inflammation of the thick band of tissue that runs across the bottom of your foot, can also put stress on your metatarsal bones and contribute to ball of foot pain, says Dr. Cotic.

• Morton’s neuroma. This is a thickening of the tissue around a nerve leading to your toes, usually between your third and fourth metatarsal bones. “It’s essentially an irritation of the nerve, which can cause symptoms such as swelling, numbness, tingling, and, at times, sharp pain,” says Dr. Cotic.

Common Treatment Options

There are plenty of things you can do to get relief from ball of foot pain. Here’s what Hinge Health physical therapists recommend for metatarsalgia treatment.

• Stay active. If pain prevents you from doing high impact activities, focus on low-impact ones such as swimming or biking for a short time, advises Dr. Cotic. It’s also important to do foot strengthening and stretching exercises. These will help surrounding muscles and ligaments get stronger and take pressure off the ball of your foot. See the next section for ideas to get you started.

• Make sure your shoes fit you correctly. Almost three-fourths of people wear shoes that are the wrong length or width for their feet, according to a study published in the Journal of Foot and Ankle Research. “Typically, if a shoe is narrower and tighter, it’s more likely to cause pain in the ball of your foot,” says Dr. Cotic. When shopping for shoes, it’s always a good idea to get your feet measured, even if you think you know your shoe size, to make sure you get the right size and width. And it might help to shop for shoes later in the day, since your feet swell a bit as you walk on them. You also want to replace shoes regularly. Hinge Health experts suggest changing shoes every 350 to 500 miles. This is when athletic shoes tend to lose their cushioning and support, which can put extra stress on the ball of the foot.

• Consider orthotics. Orthotics are inserts that you place inside your shoe to help support the foot and ankle. These are especially useful if your ball of foot pain is due to an anatomical issue such as high arches, says Dr. Cotic. You can first try over-the-counter inserts, and if that doesn’t help, see a foot specialist who can have them custom made.

• Use metatarsal pads. Similar to orthotics, metatarsal pads are cushioned inserts that you place in your shoes, but they rest under the balls of your feet. They provide more cushioning at your metatarsal joints, which helps take pressure off the balls of your feet, advises Dr. Cotic. Research shows they can help relieve foot pain, including ball of foot pain. A physical therapist can help you pick one that’s best for you.

Stretching and strengthening the muscles in and around the balls of your feet can help ease pain, aid in recovery, and prevent future problems. These ball of foot pain exercises, recommended by Hinge Health physical therapists, are a great place to start.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Keep Your Feet and Ankles Strong

When it comes to strength training, you probably automatically think of your legs, core, and arms. But your ankles and feet are just as important. “The foot is the first thing to strike the ground and leads to a chain reaction for the rest of your lower body,” explains Dr. Cotic. “Keeping your feet and ankles strong and mobile can go a long, long way for the rest of your body.”

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. MacGregor, R., & Byerly, D. W. (2021). Anatomy, Bony Pelvis and Lower Limb, Foot Bones. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557447/

2. Männikkö, K., & Sahlman, J. (2017). The Effect of Metatarsal Padding on Pain and Functional Ability in Metatarsalgia. Scandinavian Journal of Surgery: SJS: Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society, 106(4), 332–337. doi:10.1177/1457496916683090

3. Buldt, A. K., & Menz, H. B. (2018). Incorrectly fitted footwear, foot pain and foot disorders: a systematic search and narrative review of the literature. Journal of Foot and Ankle Research, 11(1). doi:10.1186/s13047-018-0284-z

4. Federer, A. E., Tainter, D. M., Adams, S. B., & Schweitzer, K. M. (2018). Conservative Management of Metatarsalgia and Lesser Toe Deformities. Foot and Ankle Clinics, 23(1), 9–20. doi:10.1016/j.fcl.2017.09.003