Therapeutic goals
Reduction of neuropathic pain in the forefoot.
Reduction of intermetatarsal nerve compression.
Improved forefoot mobility.
Strengthening of the intrinsic foot muscles.
Improved control of the foot arch and of weight distribution across the foot.
Prevention of recurrence and gradual return to activities.
Techniques used
Pain-relieving physical therapy as indicated. Massage therapy and myofascial release of the forefoot. Intermetatarsal decompression work. Gentle mobilisation of the metatarsophalangeal joints.
Mobilisation of the forefoot and the intermetatarsal spaces. Loosening of the plantar fascia. Stretching of the posterior chain if needed.
Progressive strengthening of the intrinsic foot muscles to improve forefoot stability and load distribution.
Single-leg balance exercises. Work on a balance cushion. Work on control of forefoot loading.
Work on plantar weight distribution. Advice on suitable footwear (wide toe box, moderate heel). Education on compressive factors. Gradual return to sporting activities.
Exercise programme
- Short foot exercise (activation of the foot arch)
- Picking up objects with the toes
- Scrunching a towel with the toes
- Active toe spreading (toe spread exercise)
- Controlled heel raises
- Controlled barefoot walking on a stable surface
Protocol details
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