Metatarsal pads, also known as met pads, are small pads that are placed under the center of the foot to provide relief to the metatarsal heads in the ball of the foot. These pads come in various shapes and sizes, including adhesive, elastic, and free-floating options, and can be shaped like circles, triangles, or teardrops. Unlike many other support devices, met pads do not restrict the movement of joints and muscles but instead work in harmony with the natural movement of your feet. Met pads can be useful tools for treating common foot pains like capsulitis, neuroma, plantar fasciosis, hammertoes, and more. It’s important to note that met pads need to be placed in the correct position under the feet to work properly, otherwise, they may actually increase the risk of injury. This article explains how metatarsal pads work and what they can be used for.
Why Use Met Pads?
The long bones of the foot (metatarsals), similar to toes, are meant to spread out and provide a wide and stable base for your body to stand upon. However, conventional footwear often opposes this natural posture, leading to instability and painful metatarsalgia (general pain located in the ball of the foot). Shoes with narrow tapered toe boxes restrict the natural splay and movement of the toes. This compression and crowding of the toes can make the big toe dysfunctional and increase pressure on the metatarsal heads, leading to pain and discomfort in the ball of the foot. Shoes with toe spring (also known as a rocker sole with an upward curve at the toe area) lift the toes off the ground. This lifted-toe position alters foot and gait biomechanics by limiting toe flexion and the use of the toes during propulsion. Lifted-toe position also displaces the metatarsal fat pads that provide cushioning and protection to the metatarsal heads, leaving the metatarsals more vulnerable to pressure and impact. Wearing shoes with heel elevation shifts the body’s weight forward, placing excessive pressure on the forefoot and metatarsal heads. Met pads, when used in conjunction with natural footwear, help correct such issues by supporting and spreading the metatarsal shafts while relieving pressure on the metatarsal heads.
How Met Pads Work
Met pads work by providing support to the metatarsal shafts and relief to the metatarsal heads in the ball of the foot. These small pads are placed under the center of the foot, just behind the metatarsal heads. They gently press into the bottom of the foot, encouraging the toes to lie flat and the metatarsals to spread.
Restore Toe Alignment & Toe Muscle Imbalance
Years of wearing conventional footwear with a tapered toe box, toe spring, and heel elevation will often lead to an imbalance in the muscles responsible for toe flexion and extension. These shoe design features keep the toes lifted and extended, resulting in overactive toe extensors and elongated toe flexors. By placing a met pad in the center of the foot, just behind the ball of the foot, you can provide crucial support to the metatarsal shafts and alleviate pressure on the metatarsal heads. Met pads work on a muscular level to restore balance by shortening the toe flexors and lengthening the toe extensors, ultimately promoting natural toe alignment with toes spread out and lay flat on the ground. When the toes regain their natural position, they can effectively participate in weight-bearing activities as they were originally designed to do.
Redistribute Forefoot Pressure
By encouraging the metatarsals to spread and the toes to lay flat on the ground, met pads can help redistribute pressure away from the central ball of the foot to the entire ball of the foot and all five toes. A wide and flat forefoot encourages broad pressure distribution, making it easier for the rest of the foot to function. If you were doing push-ups or a handstand, would you do it with your fingers squished together and lifted off the ground, or would you spread your fingers out and keep them flat on the ground? The more you can use your toes, the better your foot will function.
Metatarsal Fat Pad Relocation
Met pads are essential for positioning the metatarsal fat pad, a thick connective tissue that acts as a natural shock absorber across the ball of the foot. By aligning the fat pad beneath the metatarsal heads, met pads provide optimal cushioning and protection during weight-bearing activities. Conventional footwear with toe spring can displace the fat pad over time, leaving the metatarsal heads and surrounding structures vulnerable to excessive pressure and potential foot conditions. Met pads help restore the fat pad to its protective position, reducing the risk of common foot conditions that affect the bottom of the foot. By supporting proper fat pad alignment, met pads contribute to long-term foot health and comfort.
What Can Met Pads Help With?
*Always check with your doctor before implementing new treatment options*
Capsulitis
Capsulitis refers to the inflammation of the joint capsule and surrounding ligaments in the joints in the ball of the foot. It commonly affects the metatarsophalangeal joints (the joints between the metatarsal bones and the toes). Met pads can help with capsulitis by providing support and reducing pressure on the affected joints. The pads help to redistribute weight evenly across the foot, relieving stress on the inflamed ligaments and promoting proper alignment. By reducing excessive pressure and offering cushioning, metatarsal pads can alleviate pain, swelling, and discomfort associated with capsulitis.
Interdigital Neuroma (Morton’s Neuroma)
A neuroma is a painful condition characterized by the thickening of nerve tissue, often occurring between the metatarsal heads in the ball of the foot. Met pads can help alleviate the symptoms of neuroma by reducing the pressure and compression on the affected nerves. By redistributing the weight and providing cushioning, met pads help create a more supportive environment for the metatarsal heads, relieving the pain and discomfort associated with neuromas.
Plantar Fasciosis
Plantar fasciosis is a condition characterized by degeneration of the plantar fascia, a thick band of tissue that runs along the bottom of the foot, connecting the heel to the toes. It often causes heel pain and discomfort, especially during the first steps in the morning or after prolonged periods of rest. Meta pads can help with plantar fasciosis by providing support to the metatarsal heads and promoting proper foot alignment. By redistributing pressure away from the inflamed area of the plantar fascia, metatarsal pads help reduce strain on the fascia, allowing it to heal and recover. Met pads do this by returning the plantar fascia to its naturally arched shape and encouraging the plantar foot muscles to contract and support the foot intrinsically. Met pads also help to improve weight distribution across the foot, reducing excessive stress on the heel and promoting a more natural gait.
Hammertoes
Hammertoes are a common condition in which the muscles that flex and extend the toes become imbalanced, leading to abnormal bending or curling of one or more toes. It can cause discomfort, pain, and difficulty in wearing shoes comfortably. Met pads can help with hammertoes by addressing the underlying muscle imbalance and promoting proper toe alignment. Met pads, placed in the center of the foot behind the ball of the foot, support and spread the metatarsal shafts, relieving pressure on the metatarsal heads. They help shorten the toe flexor muscles and lengthen the toe extensor muscles, encouraging a more neutral toe posture with the toes lying flat on the ground surface. This can help realign the toes and alleviate the symptoms associated with hammertoes. By promoting natural toe alignment, met pads enable the toes to better participate in weight-bearing functions as they were intended to, reducing discomfort and improving foot function.
Metatarsal Pad Placement
Met pads should typically be placed in the center of the foot, just behind the ball of the foot. This positioning helps to support the metatarsal shafts and distribute pressure evenly across the metatarsal heads. Look for indents or marks your feet may have left in the shoe or insoles and place the met pads just behind the ball of the foot. This should be close to the middle third of the shoe or insole. The exact placement may vary depending on the individual’s foot structure and specific needs. It’s recommended to consult a healthcare professional or a podiatrist for guidance on proper placement and to ensure optimal effectiveness and comfort. For a more detailed guide to placing met pads, check out this met pad placement blog post or video.
Kinds of Met Pads
- Adhesive | Pedag T-Form met pads stick inside the shoe, either on or under the insole. Because of the adhesive, these met pads are not easily moved from shoe to shoe unless they are placed on an insole that fits many of your shoes. The upper is made from nice leather and the foam is very durable, retaining its shape well over time, even with extensive use.
- Elastic | Strutz met pads are sewed to an elastic band that wraps around the top of the foot. This met pad can be worn without shoes so it has the benefit of supporting your feet while barefoot. However, for some people, these met pads can feel a little cumbersome when worn within footwear.
Progressive | Barefoot Science met pads are insoles that have a hollow cavity in the location where the met pad is. This hollow cavity can be filled with 7 differently sized pegs to progressively increase the height of the met pad. As the met pad size increases, the foot muscles contract more and arch muscles gradually strengthen.
3/4-length Insole | Bridge Soles are soft, flexible insoles with slight heel padding and arch support. They are designed to alleviate many common foot pains and ease the transition in of feet from supportive shoes to natural footwear. For best fit, we suggest using one size smaller than the manufacturer’s sizing recommendations.
Written by: Dr. Andrew Wojciechowski, ND
If you’re seeking more individualized foot health care and would like to work with Dr. Andrew directly, you can schedule at Northwest Foot and Ankle.
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