The sole of your shoe wears the most rapidly at the ball of your foot, and your shoe may get a hole in it at that point. This is the point of greatest stress when we walk.
We make it even worse by wearing footwear designed for fashion rather than function. And, unfortunately, this area is where the metatarsal bones join the toe bones. A great proportion of the arthritis that affects the foot occurs at these joints.
The consequences of arthritis in the forefoot is major and adverse. With every step we place weight on this area, and it is difficult indeed to walk without using the forefoot. Even a small problem can make walking difficult, and then the other muscles, tendons, ligaments, and bones begin to lose strength. Serious attention is required because your careful work at home can pay major dividends. Even people with major arthritis will find that attention to local factors can make all the difference.
The basic principle is quite simple. The idea is to move the weight-bearing burden away from the painful part so that the inflammation can subside and the part can heal.
The metatarsal bar, a strip of sole leather that the shoemaker can sew or glue onto the outside of your shoe about an inch behind the contact point where you are wearing out the sole, is an important device to shift your weight.
When you check your area of greatest pain against the area of greatest wear in the shoe, you will find that they are at the same place. Press on your foot about an inch behind the sore place and you will note how much better it feels and how the toes line up straighter.
The metatarsal bar will also help your arch. It is an inexpensive device, and any good shoemaker knows how to fit one. Fix several pairs of shoes. An insert in the shoe can do the same thing. Cut the insert so that the sore place is not supported by the insert. These inserts have the advantage that they can be transferred from shoe to shoe.
Good shoes are critical to the problems of foot pain. Don't wear shoes with pointed toes. Women should avoid high heels. They throw additional weight on the forefoot.
Look for a wide toe box in a shoe. You can a lot in the store by walking around before buying; don't go home with a purchase that isn't comfortable no matter what the salesperson says. Try the athletic shoe department for casual shoes. These shoes are excellent for arthritis and should be more widely used, they are comfortable and less expensive. Look for shoes with a good heel wedge support, a nylon upper that will spread in the toe box, and laces that run through guides rather than eyelets so that they adjust smoothly. Shoes with air cushions seem particularly satisfactory for many people.
If your problem with pain in the forefoot occurs at night, you will need something to raise the covers off the foot. A pillow under the covers at the bottom of the bed is the easiest solution, a side-lying L-shaped piece of wood may be better for tall people.
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