Forefoot pain can be a pain in the foot! If you’ve never experienced long term forefoot pain – then good for you! However, if you’ve been experiencing forefoot pain for weeks, months, or even years, the often key to resolving the problem is via addressing the cause of the pain, not by focussing on the pain itself.
Most people are able to identify they have a sore forefoot. There’s a good chance that if you are reading this, you have a sore forefoot or someone with a sore forefoot. Imaging such as x rays, ultrasounds or even MRI’s are great at identifying what is injured, whether it be a fracture, capsulitis, bursitis, tendinopathy or even neuroma. But sometimes imaging does not offer information helpful for a successful long-term management plan as imaging does not often provide information about why the problem occurred in the first place.
For chronic or gradual onset injuries, understanding what is injured or causing pain is important. Understanding why you became injured or what is causing the pain is equally important if you would like to resolve the issue with a successful long-term management plan and return to great physical performance.
This is where the assessment and history taking is most important for the treating practitioner to offer you a sound management plan that also addresses the cause of forefoot pain to make sure the pain is resolved for good.
For chronic forefoot pain, it is essential for your practitioner to have an understanding of:
- Where it is painful?
- How long it has been painful?
- What makes it worse?
- What makes it better?
- What daily repetitive tasks do you perform?
It is also essential for your practitioner to conduct a thorough physical assessment where your treating practitioner is assessing range of motion, muscular ability via muscle testing, and pain via palpation (touching). This information should not be obtained from just from your forefoot, but from your ankle, leg, knee, hip, etc. to understand how other areas of your body may be contributing to forefoot pain. Your practitioner cannot provide a thorough physical assessment without actually physically touching you, or understand how the rest of your body may be contributing to pain without assessing those other areas of your body.
Dynamic assessments are also essential. This includes biomechanical assessment where your treating practitioner is assessing your movement, balance and loading of certain areas in your body that may increase the chance of injury. Again, this information should not be obtained from just from your forefoot, but from your ankle, leg, knee, hip, etc. to understand how the way other areas of your body move and behave and how they may be contributing to forefoot pain. Your practitioner cannot provide a thorough dynamic assessment without actually watching you move or behave when performing certain movement-based tests.
We often have many clients attending our clinic that have tried different management techniques before. A theme that emerges in these cases is that what they have tried in the past has not addressed the cause of the forefoot pain but is rather focussed on the forefoot pain itself.
A thorough assessment including thorough history taking, physical assessment and dynamic assessment is essential for understanding each person’s forefoot pain and their unique factors that have contributed to their own forefoot pain. With this information clearly understood, only then can you be confident of addressing forefoot pain with a clearly explained long term management plan. This approach not only offers relief from pain, but also offers an educational experience about your own body and how it works.
Podiatrist, Strength & Conditioning Coach