Do You Have Pain in the Ball of Your Foot? How to Diagnose and Treat Capsulitis
When you mention foot injuries, most people think of Achilles tendonitis, stress fractures or the dreaded plantar fasciitis. While these afflictions seem to be the most popular, especially among runners, it is possible that pain in your forefoot could be the result of another common ailment: capsulitis.
No, it isn't the name of a Greek war hero. Capsulitis is a condition that affects the joints behind your toes. These joints are covered in ligaments that form capsules to help keep your bones moving smoothly. If those capsules become inflamed then you have capsulitis. Although this can happen to any joint in your body, it seems to be most common in the ball of your foot, especially behind your second toe.
So how do you know if you have capsulitis? It can be a painful condition, often accompanied by swelling and redness in the affected area. Walking with the inflamed capsules will often feel like you're landing on a stone with every step. If left untreated, chronic capsulitis can lead to the formation of painful calluses that feel as if they have a core or seed inside of them.
Be aware that capsulitis symptoms can be very similar to the symptoms of neuromas. Click here to learn about neuromas.
According to Dr. Ray McClanahan, podiatrist at Northwest Foot and Ankle, capsulitis is often caused by excessive weight-bearing beneath the affected toe joint, but these factors can increase the likelihood of the inflammation developing:
- Extreme bunion deformity.
- A second toe that is longer than your first toe.
- An unstable foot arch.
- Tight calf muscles on your involved side.
- Imbalance between the muscles on top of and below your feet (extensors and flexors).
- Regular use of footwear with an elevated heel, tapered toe box and/or toe-spring.
Dr. McClanahan believes that toe springs (shoe designs that force toes to be held in an upward position) and tapered toe boxes may be the most common causes of capsulitis. Both of these features, often found in conventional shoes, alter the way weight is distributed on our feet when we walk. Toe springs increase pressure under the joints where capsulitis often occurs, and tapered toe boxes squeeze your toes together, often taking much weight off the big toe and distributing it to the second toe.
The good news is that capsulitis can often be relieved with simple non-surgical treatment, especially if it is caught at an early stage. Here are Dr. McClanahan's recommendations for dealing with the condition:
- Rest: reducing weight-bearing activities can help control your symptoms.
- Ice: icing your affected area can minimize your pain and swelling.
- Taping or Splinting: proper taping helps align your involved toe and prevents your toe from drifting.
- Stretching: stretching may be particularly important for those who have tight calf muscles or foot extensor/flexor imbalance.
- Anti-Inflammatory Agents: supplements or medications can help reduce pain and swelling.
- Footwear Therapy: shoes with little or no toe-spring and wide toe boxes may be most helpful. Also, toe spacers like Correct Toes and metatarsal pads placed in your shoe can help return your foot’s fat pad to its rightful, protective location under your metatarsal heads.
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For more information on finding for shoes that allow your feet to move and develop naturally, check out our Barefoot Shoes Shopping Tips. Please remember that it is always recommended to seek the advice of a medical professional for an accurate diagnosis and treatment plan.
For more information: Dr. Ray McClanahan. "Capsulitis" Correct Toes (July 1, 2013)
Martin is a lifelong runner who began wearing minimalist shoes over 10 years ago when he found they alleviated his chronic foot pain, which eventually disappeared completely. He further studied proper running form through a series of workshops taught by Correct Toes inventor, Dr. Ray McClanahan DPM. Martin has collaborated with several health care professionals to collect and share peer-reviewed studies that show the benefits of minimalist footwear. In his personal life, Martin loves living in the Pacific Northwest because it allows him to enjoy a variety of outdoor activities year-round, including hiking, cycling, rock climbing, surfing and snowboarding.