Explanation of Diagnosis

Metatarsalgia is pain and inflammation in the ball of the foot, typically caused by increased pressure on the metatarsal bones (the long bones just behind the toes). It commonly occurs due to high-impact activities, improper footwear, foot deformities, or excessive weight-bearing. Symptoms include sharp, aching, or burning pain in the forefoot, especially when walking, running, or standing for long periods.

Specific Work Modifications

• Avoid prolonged standing or walking on hard surfaces.
• Use cushioned, supportive footwear with a wide toe box to relieve pressure.
• Consider orthotic inserts or metatarsal pads to distribute weight evenly.
• Take frequent sitting breaks to reduce foot strain.
• If standing is necessary, use anti-fatigue mats to minimize pressure on the feet.

Specific Activity Modifications

• Avoid high-impact activities like running, jumping, or dancing.
• Modify workouts by switching to low-impact exercises such as cycling, swimming, or elliptical training.
• Wear proper athletic shoes with forefoot cushioning if engaging in sports.
• Limit barefoot walking on hard surfaces.

Recommended Supplements

• Collagen peptides (10 g daily) – Supports foot joint and soft tissue repair.
• Vitamin D3 (1000-2000 IU daily) – Aids in bone and joint health.
• Calcium (1000-1200 mg daily) – Strengthens bones and prevents stress fractures.
• Magnesium (300-400 mg daily) – Helps with muscle relaxation and foot cramping.
• Omega-3 fatty acids (1000 mg daily) – Reduces joint inflammation.

Recommended Nutrition and Hydration

Diet Recommendations:

• Bone-supporting foods: Dairy products, almonds, leafy greens, and fortified cereals for calcium.
• Anti-inflammatory foods: Fatty fish (salmon, sardines), turmeric, berries, and walnuts.
• Protein-rich foods: Chicken, eggs, lentils, and dairy to support foot tissue recovery.
• Limit processed foods, excess sugar, and alcohol, which can worsen inflammation.

Hydration Tips:

• Drink at least 2–3 liters of water daily to prevent muscle cramping and maintain joint lubrication.
• Limit caffeine and alcohol, which can dehydrate tissues and slow recovery.

Home Exercise Prescription

Perform 2-3 times daily to improve foot flexibility, reduce pain, and strengthen the forefoot:

1. Toe Stretch

1. • Sit down and gently pull the toes back toward the shin.
   • Hold 20-30 seconds, repeat 3 times per foot.

2. Metatarsal Doming (Foot Arch Strengthening)

1. • Sit or stand and try to lift the arch of your foot without curling the toes.
   • Hold for 5 seconds, repeat 10 reps per foot.

3. Toe Towel Scrunches

1. • Place a towel on the floor and use your toes to scrunch it toward you.
   • 10 reps, 2 times daily.

4. Rolling Massage with a Ball

1. • Use a tennis ball or frozen water bottle under the foot and roll it gently back and forth.
   • 1-2 minutes per foot, 1-2 times daily.

5. Calf Stretch (Straight & Bent Knee)

1. • Stand facing a wall and place one foot back to stretch the calf.
   • Hold for 20-30 seconds, repeat 3 times per leg.

Avoid walking barefoot, high-impact activities, and tight-fitting shoes until pain resolves.

Helpful Books

1. "Fixing Your Feet: Injury Prevention and Treatment for Athletes" – John Vonhof
2. "Every Woman’s Guide to Foot Pain Relief: The New Science of Healthy Feet" – Katy Bowman

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.