So, as the weather was poor outside and I didn’t want to drag the bike out I went for a run just prior to Christmas, a longer run than I’ve done for a while. Since then I’ve developed what I think is metatarsalgia in my left forefoot….sore bruising under the front pad and a pebble like sensation when walking on it.

Due to the lack of availability of physio etc at this time have you any experience or advice you could offer me to help deal with it?

Thanks in advance!

I have this, diagnosed through an MRI scan or metatarsal bursitis to be exact. Consultant sent me for a cortisone injection and then essentially prescribed rest for a couple of months, so no cycling/running or anything that would work the foot to a great degree. He suggested swimming for exercise but, well….covid. Wear shoes that allow space for your feet and maybe worth trying metatarsal pads in your regular shoes. That said the cortisone didn’t seem to make any difference for me, nor has the rest period which has been massively frustrating. Google suggests that a lack of recovery is not uncommon and people just continue with the issue unless it worsens, developing into mortons neuroma which then needs an op, slightly ominous for you given the pebble feeling. I plan to go and see the consultant again when things settle down but at the moment ive gone back to riding, rightly or wrongly, as doing nothing with no recovery was irritating me. If it worsens ill stop but until then….

Oh wow sorry to hear that and it sounds a bit grim! I’ll give it a bit longer but similarly no exercise is not an option.

Sympathise. In my experience go and see a good private podiatrist ASAP if at all possible. Decades of sub-par podiatry service from the NHS in my necks of the woods have left me in constant pain. One even measured my feet wrongly and recommended I wear smaller shoes (a whole size and a half smaller). One of his colleagues corrected this two or three years later when she saw me and asked ‘who measured your feet? You’re a 9-9.5, not an 8’ 😡😡😡

I’ve since tried to unravel the pain with a lot of self-care, footwear experiments and physio, and with some success. Hindsight? I should have pulled out all stops and gone private/seen a sports pod.

You can also seek some guidance in self-examination and may (maybe with help from a partner?) be able to distinguish between metatarsalgia or Morton’s/digital neuroma. I have both conditions and found a few ways to improve the pain

Pain IME is somewhat like that playground torture at school when someone squeezes your fingers either side of a pencil, combined with walking on stones that have sewn into the space where your toes join your foot.

Measurable successes from:

– Custom insole with metatarsal dome helped to a degree. This was via the NHS
– Calf-stretches and one-leg heel-raises* (I did heel raises morning and night, 3 minutes whilst brushing teeth as is easy to schedule and helps focus on tooth care also! Difficult at ut after 3 weeks there was a tremendous reduction in pain and increase in mobility.
– Wider shoe/bigger toe-box in shoe (this was the difference between being 1. able to walk with some pain and 2. Being unable to walk without hobbling and clenching teeth in pain
– Single speeding MTBing with wide flat pedals (it’s an aggressive foot-massage without you even knowing it. It helped disperse some of the ‘sticking’ and pain. Quite a lot actually.

The heel raises, calf-stretches and wider shoes make the most difference IME.

YMMV, IANAD/P etc.

* link to heel raises
https://www.fairview.org/sitecore/content/Fairview/Home/Patient-Education/Articles/English/f/o/o/t/_/Foot_and_Ankle_Exercises_SingleLeg_Heel_Raise_89909

video explaining differences

Physios are open here – worth checking

Thanks all for the information. Very frustrating but this will give me something to work on! I’ll update if anything changes for future reference for others if this is useful!