Pedorthic Management
Metatarsalgia - ANS--Generic term for pain in the forefoot/ball from repetitive stress, associated
with a drop or collapse of the metatarsal arch causing the soft tissue to be pinched or trapped
between the bones
Metatarsalgia treatment - ANS--reduce and redistribute forefoot pressure, reduce painful joint
motion, and correct any forefoot malalignment
Metatarsalgia foot orthotic - ANS--Total contact to transfer forefoot pressure into the longitudinal
and metatarsal arches
-Post adjacent metatarsals heads as necessary
-Shock absorbent materials under metatarsal heads and toes
Metatarsalgia shoewear - ANS--Lower heel to reduce forefoot and metatarsal head pressure
-Utilize shock absorbent soling
-Utilize longer and wider shoe to reduce medial-lateral circumference pressures
Metatarsalgia shoe modification - ANS-Rocker bottom sole to reduce forefoot motion and
pressures
-metatarsal bar to shoe to shift pressure proximally
-negative heel modification
-excavation under painful metatarsal
Morton's Interdigital Neuroma - ANS-Perineural fibrosis- type of nerve compression syndrome
which involves the common digital nerves of the lesser toes (often 3rd, 2nd)
-reduce forefoot pressure, reduce metatarsal compression to relieve interdigital nerve
entrapment and limit friction or shear inside of shoe
Morton's Interdigital Neuroma foot orthotic - ANS--total contact orthosis with a metatarsal pad to
transfer pressure to the longitudinal and metatarsal arches
-shock absorbent material under metatarsal heads (viscoelastic polymers or silicones)
Morton's Interdigital Neuroma shoewear - ANS--utilize longer or wider shoe to reduce ML and
circumferential or radial pressures
-lower heel to reduce metatarsal head pressure
-long medial counter to support long arch
Morton's Interdigital Neuroma shoe modifications - ANS--Rocker sole to shoe to reduce FF
motion and pressures
-Carefully placed metatarsal pad to elevate and separate metatarsals
-Metatarsal bar to shift pressures proximally
, Morton's Toe - ANS-Congenital short first met, a hypermobile first met, and calluses under the
2nd and 3rd met.
-reduce forefoot pressure, reduce 2nd MTPJ pressure, and limit friction or shear inside of shoe
Morton's Toe foot orthotics - ANS--total contact with a metatarsal pad and 1st toe extension to
transfer pressure to the longitudinal and metatarsal arches
-shock absorbent material under metatarsal heads
Morton's Toe shoewear - ANS--shock attenuating vibram sole to reduce plantar pressures
-lower heel to reduce metatarsal head pressure
-long medial counter to support long arch
Morton's Toe shoe modification - ANS--rocker sole to shoe to reduce FF motion and pressures
- carefully placed met pad to elevate and separate mets
-met bar to shift pressures proximally
Hallux Valgus "Bunion" - ANS-Hallux abducto valgus is an enlargement of bone and/or soft
tissue around the joint at the base of the first MTPJ associated with abnormal rotation of the
great toe and abnormal drifting or inward leaning of the great toe towards the 2nd toe and
adduction of the met
-reduce pressure and friction to the first MTPJ and hallux
-improve forefoot pressure distribution
-reduce profanatory forces
-correct any malalignment
Hallux Valgus Bunion foot orthotic - ANS--total contact with a met pad to transfer forefoot
pressures into longitudinal and metatarsal arches
-shock absorbent materials under met heads and toes
Hallux Valgus Bunion shoewear - ANS--bunion last to accommodate foot shape
-deep and wide toe box (oblique) with soft leather (deerskin) uppers to reduce pressure
-utilize longer and wider shoes to reduce ML circumferential pressures
-utilize shock absorbent soling
-thermal moldable shoe
Hallux Valgus Bunion shoe modification - ANS-Rocker bottom sole to reduce forefoot pressures,
and stretch or balloon patch 1st and 5th MTH
Hallux Rigidus - ANS-Degenerative type of arthritis that affects the MTPJ, the condition may
follow any injury to the joint resulting in decreased ROM
Metatarsalgia - ANS--Generic term for pain in the forefoot/ball from repetitive stress, associated
with a drop or collapse of the metatarsal arch causing the soft tissue to be pinched or trapped
between the bones
Metatarsalgia treatment - ANS--reduce and redistribute forefoot pressure, reduce painful joint
motion, and correct any forefoot malalignment
Metatarsalgia foot orthotic - ANS--Total contact to transfer forefoot pressure into the longitudinal
and metatarsal arches
-Post adjacent metatarsals heads as necessary
-Shock absorbent materials under metatarsal heads and toes
Metatarsalgia shoewear - ANS--Lower heel to reduce forefoot and metatarsal head pressure
-Utilize shock absorbent soling
-Utilize longer and wider shoe to reduce medial-lateral circumference pressures
Metatarsalgia shoe modification - ANS-Rocker bottom sole to reduce forefoot motion and
pressures
-metatarsal bar to shoe to shift pressure proximally
-negative heel modification
-excavation under painful metatarsal
Morton's Interdigital Neuroma - ANS-Perineural fibrosis- type of nerve compression syndrome
which involves the common digital nerves of the lesser toes (often 3rd, 2nd)
-reduce forefoot pressure, reduce metatarsal compression to relieve interdigital nerve
entrapment and limit friction or shear inside of shoe
Morton's Interdigital Neuroma foot orthotic - ANS--total contact orthosis with a metatarsal pad to
transfer pressure to the longitudinal and metatarsal arches
-shock absorbent material under metatarsal heads (viscoelastic polymers or silicones)
Morton's Interdigital Neuroma shoewear - ANS--utilize longer or wider shoe to reduce ML and
circumferential or radial pressures
-lower heel to reduce metatarsal head pressure
-long medial counter to support long arch
Morton's Interdigital Neuroma shoe modifications - ANS--Rocker sole to shoe to reduce FF
motion and pressures
-Carefully placed metatarsal pad to elevate and separate metatarsals
-Metatarsal bar to shift pressures proximally
, Morton's Toe - ANS-Congenital short first met, a hypermobile first met, and calluses under the
2nd and 3rd met.
-reduce forefoot pressure, reduce 2nd MTPJ pressure, and limit friction or shear inside of shoe
Morton's Toe foot orthotics - ANS--total contact with a metatarsal pad and 1st toe extension to
transfer pressure to the longitudinal and metatarsal arches
-shock absorbent material under metatarsal heads
Morton's Toe shoewear - ANS--shock attenuating vibram sole to reduce plantar pressures
-lower heel to reduce metatarsal head pressure
-long medial counter to support long arch
Morton's Toe shoe modification - ANS--rocker sole to shoe to reduce FF motion and pressures
- carefully placed met pad to elevate and separate mets
-met bar to shift pressures proximally
Hallux Valgus "Bunion" - ANS-Hallux abducto valgus is an enlargement of bone and/or soft
tissue around the joint at the base of the first MTPJ associated with abnormal rotation of the
great toe and abnormal drifting or inward leaning of the great toe towards the 2nd toe and
adduction of the met
-reduce pressure and friction to the first MTPJ and hallux
-improve forefoot pressure distribution
-reduce profanatory forces
-correct any malalignment
Hallux Valgus Bunion foot orthotic - ANS--total contact with a met pad to transfer forefoot
pressures into longitudinal and metatarsal arches
-shock absorbent materials under met heads and toes
Hallux Valgus Bunion shoewear - ANS--bunion last to accommodate foot shape
-deep and wide toe box (oblique) with soft leather (deerskin) uppers to reduce pressure
-utilize longer and wider shoes to reduce ML circumferential pressures
-utilize shock absorbent soling
-thermal moldable shoe
Hallux Valgus Bunion shoe modification - ANS-Rocker bottom sole to reduce forefoot pressures,
and stretch or balloon patch 1st and 5th MTH
Hallux Rigidus - ANS-Degenerative type of arthritis that affects the MTPJ, the condition may
follow any injury to the joint resulting in decreased ROM
