Forefoot pain can have various causes. One of the causes can be a foot malposition, which leads to an incorrect load on the forefoot and causes pain. Poor footwear (high shoes or shoes that are too small), overweight, lack of strength in the foot muscles or previous injuries can be the cause of the complaints.
The feet are enormously important for the rest of the body’s statics and should be treated accordingly to avoid subsequent problems. If there is a foot malposition, it can be compensated by appropriate insoles, but it is more important to strengthen the corresponding arch muscular system. Bad footwear should be avoided, if it concerns an athlete, an improvement can be achieved with appropriately cushioned and adapted sports shoes.
In case of overweight, the weight should be reduced and in case of a strength deficit, the corresponding musculature in the area of the foot or lower leg should be trained. Depending on the extent of the previous injuries, mobility should be restored, which is probably why the pain was triggered. In principle, all possible directions of movement in the foot are suitable for mobilizing the foot.
In the upper ankle joint, the foot is lifted and stretched and in the lower ankle joint, the foot is “turned” inwards (pronation) and outwards (supination). The hindfoot and forefoot area supports the respective movement. The rolling motion during walking should be done consciously and walking barefoot in between improves proprioception.
If there are restrictions of movement in a certain direction, a physiotherapist in the pre-treatment can solve the restriction in advance by using certain techniques. The following exercises can help the patient to improve his mobility. Further exercises can be found in the articles Mobilization exercises and exercises for gait disorders.
- Wringing of forefoot and hindfoot: Patient grips the foot at the heel and forefoot and twists the foot against each other (like wringing a cloth)
- Claw toes: pull toes to the heel, as if you want to make the foot shorter
- Stretch toes: Deliberately overstretch toes so that only the ball of the toe stands up
- Circle the foot: this mobilizes all 4 directions of movement
- Stand on your toes: stretch to the tips of your toes
- Heel drop: stand on the heel and lift toes in front
- Penguin: Heels stay pressed together, toes stand at a certain distance from each other, stand on your toes. This results in a twisting of the arch of the foot, which is absolutely necessary for muscular stabilization. The forefoot and ankle joint are also mobilized against each other.
- Walking over uneven surfaces, such as various carpets, wobble plates, sand, stones, etc.
improves proprioception/coordination and stimulates the blood circulation, which can lead to improved mobility through the metabolic process.
For good mobility and improvement of pain in the foot and especially in the forefoot, it is also important to examine the muscles surrounding the foot in addition to direct mobilization. Especially the plantar tendon, which extends under the sole of the foot, is often shortened and can therefore cause pain in the area of the tendon or, in the absence of treatment, even cause a heel spur. Further exercises can be found in the articles
- To stretch this tendon, the patient stands on a step with his toes and lets his heel down to the floor.
He remains in this position for 20-30 seconds and releases the traction again.
- The patient can also perform a transverse stretching of the sole of the foot himself by hooking his thumb across the course of the tendon and stretching it to the side.
- In addition to the plantar tendon, the calf muscles should also be elastic enough to allow enough movement in the foot. To stretch the calf muscles, the patient takes a lunge and leaves the rear heel on the floor and tries to keep it there while the body weight is pushed towards the front leg. The feet can also be placed next to each other and the patient tries to reach the floor with his hands while stretching his legs.
- Exercises for a heel spur.
- Physiotherapy for heel spurs
The transverse and longitudinal arch is essential for good foot mobility and freedom from complaints.The arch is formed by certain muscles that originate at the lower leg and pull under the foot to the toes.
These muscles can be trained by the following exercises. As mentioned above, running over different surfaces is a good way to improve the sensitivity of the foot and stimulate the blood circulation. Running further, the muscles receive input and can thus work better.
- Pick up objects: Try to pick up objects with your toes and accept them with the other foot. This not only trains the strength in the foot but also requires coordination.
- Claw toes: Pull toes to the heel –> make the foot shorter.
- Spread toes: Sometimes cannot be performed over each toe due to lack of sensitivity.
- Penguin: Heels stay pressed together, toes stand at a certain distance from each other, stand on your toes.
- Toe stand: Reinforcement by standing on one leg and by pushing up and down several times.
The following exercises are suitable for improving coordination: Standing on trampoline, Airex cushion, wobble board etc. Walking on the spot Running on the spot and stopping quickly Running and catching a thrown ball at the same time One leg stand other leg writes the numbers from 1-10 forward and backward tap with the other leg stretch other leg backward and pull up forward lift leg lift knee bend knee and bring it together with the opposite elbow lift hip 90° and stretch only the knee bend hip 90° and stretch only the knee and stretch and bend the arms upwards (pull shoulder blades together) alternatives like rowing, swinging the arms, dumbbell exercises etc.
possible All exercises in the one-legged position can also be strengthened with an Airex cushion, wobble cushion etc. For athletes, exercises from the running school are also possible in athletic training. The exercise “ankle work” in which the feet are unrolled quite quickly.
Knee lever runs, heel runs, running with stretched legs and subsequent speed training are optimal for coordination. Further exercises can be found in the articles Balance and coordination exercises and Physiotherapy exercises ankle joint.
- Walk on the spot
- Run on the spot and stop quickly
- Running and catching a thrown ball at the same time
- Other leg writes the numbers from 1-10
- Tap forward and backward with the other leg
- Stretch the other leg to the back and pull it upwards to the front
- Raise leg
- Bend knee and join with opposite elbow
- Raise hip 90° and stretch only the knee
- Bend hips 90° and stretch only the knee and stretch and bend the arms upwards (pull shoulder blades together) Alternatives such as rowing, swinging the arms, dumbbell exercises etc.
are possible
Pain in the foot is a sign of overloading. Massages are suitable to counteract the overloading of the muscles. Either performed by another person or by yourself.
The plantar tendon can be loosened and tension in the heel area can be released. The calf should be treated as well, since it controls the movement of the foot. By pressing a tense point for several seconds the tension can be released (trigger point massage).
Extensive massages in the area of the calf and the Achilles tendon give looseness in the ankle joint. In addition, a fascia roller or hedgehog ball can be used to loosen the fascia and activate proprioception. It is important that during the acute phase, applications are carried out regularly to achieve rapid improvement.
Pain in the forefoot can have many different causes, which can be found out by a detailed anamnesis by the doctor or physiotherapist. A foot malposition can be the cause as well as often bad footwear (high shoes or shoes that are too small), overweight, a lack of strength in the foot muscles or previous injuries. Since a foot malposition is often caused by a weak arch, it is especially important to build up the foot muscles by holding and gripping the toes.
Restricted mobilization can also cause pain in the forefoot area in the long term. In order to improve mobility, active exercises in all directions of movement are recommended. A preparatory treatment by the physiotherapist provides a good basis for this.A coordination training is also useful to activate the CNS.
Exercises in a one-legged stand with connection of the arms, but also exercises from the athletic training of competitive athletes, are particularly suitable for this. Regenerative massages relax the overstrained muscles. In general, changing surfaces such as uneven surfaces, sand, stones, meadows are suitable for this purpose in order to increase the blood circulation and thus activate the metabolism and to prevent the metatarsal area from settling and sticking together.
