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Functional effect of a metatarsal pad

Discussion in 'Biomechanics, Sports and Foot orthoses' started by mike weber, Apr 27, 2009.


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    hi all

    Most pateints in Sweden are fitted with a Metatarsal pad (padding to dorsiflex the 2nd- 4th metatarsal heads) on the their orthotics commonly by a P & O (not by Podiatrists ) because their "forefoot has fallen" and this will help their heel, knee, hip pain . Fill in what ever sysmptoms you like apparently they all fit.

    I know of research that deals will plantar pressure changes from a metatarsal pad, but not found any in relationship to functional gait changes.

    any ideas on gait changes both negative and if any positive.

    Michael Weber
     
  2. Yes kinetic change count as fuctional gait changes.

    I was wondering If by reducing the pressure under the 2nd-4th met heads are the pads over loading up other areas such as the 1st ray or FHL. Could this cause changes in the STJ axis.
     
  3. The spatial orientation of the STJ axis within an individual, at a given point in time during walking, is largely determined by the rotational position of the joint. If the metatarsal pad changed the kinematics of the STJ, then clearly this could result in 4D changes in STJ axial position. However, changes in kinetics in isolation may have little influence on STJ axial position. Contrast the MTJ with the STJ: Nester has suggested that the MTJ axial position is chiefly determined by the forces applied to the foot, i.e. changes in kinetics will influence MTJ axial position. However, I suspect this is less true of the STJ since it is far more constrained. That is not to say that metatarsal padding does not have the capacity to alter moments about the STJ- it does. Though I don't know of any studies that have investigated this.
     
  4. Admin2

    Admin2 Administrator Staff Member

  5. Ina

    Ina Active Member

    I thought my country is among few dinosaurs in the world where metatarsal pads are routinely prescribed for every symptomatic as well as an asymptomatic splayed forefoot, colloquially referred to as a fallen transverse arch. Moreover, quite regularly parents come with metatarsal pads prescriptions for their children as young as 5-year-old, again with an asymptomatic splayed forefoot. Adult and juvenile hallux valgus is almost universally attributed to a fallen transverse arch, with metatarsal pad-added insoles as the first-line treatment. Basically, any ball of the foot pain is explained by the collapse of the transverse arch. (Maybe it's our equivalent of such an all-embracing diagnosis as metatarsalgia in the English speaking countries.)

    Apart from unknown effects of metatarsal pads on children, I would think it's irrelevant for my selling over-the-counter orthotics if the transverse arch really exists or not since anecdotally metatarsal pads are overwhelmingly so helpful for many people with the ball of the foot pain.

    I started doubt this prevalent in our country belief in the restoration of a fallen transverse arch with the help of met pads when it came to the adults with painful calluses both under the first and the fifth metatarsal heads. These calluses simply shouldn't be there if one is to believe that in the normal forefoot with an intact transverse arch most of the weight is normally borne by the first and the fifth metatarsal heads. I wonder how such concurrent the first and the fifth met heads calluses are explained in other countries (if there's still any, it's been over 6 years since the first post) where the practice of issuing orthotics is also based on the idea of restoration of a collapsed transverse arch?
     
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