The Center for Podiatric Care and Sports Medicine

Excuse Me, You Dropped Your Metatarsal

Posted by on Wednesday, August 15th, 2012


You know that expression “all your ducks in a row?” It’s such a nice idea. I like to picture a group of cheerful yellow rubber duckies, all lined up on the edge of a bathtub, ready to dive in, perfectly in sync.

The metatarsals, those long bones that connect your toe bones to your midfoot, should also line up like those ducks in that row, all nice and even with each other. That way each bone is able to share the load that your body puts on your foot with each step.

So what happens when one of those metatarsals falls out of line? Good question! Then you have a dropped metatarsal. That’s where one of the metatarsals is lower than the others.

“Dropped” metatarsal is such an easy to understand name for this injury. Don’t you have something more complicated and medical sounding? You can also call it a plantar flexed metatarsal.

That’s more like it.What would make a metatarsal drop? Is it bored? Like so many other things with your health and body, it’s inherited or just the way you’re born; the way your foot is built encourages this to happen. Faulty foot mechanics also can cause a metatarsal to drop. Arthritis or a traumatic injury can also affect the position of the metatarsal.

Say, I’m thinking this must be great for that metatarsal, finally getting to have some “alone time.” Well, no, not really. If one metatarsal is lower than the others, then it hits the ground first, taking most of the weight from each step by itself. Each bone isn’t meant to deal with that much pressure by itself. As a result, the tissues around the dropped metatarsal can become inflamed and painful. The fat pad that helps protect the metatarsal can wear down, and a callus can develop on the skin.

Oh, well, none of that sounds very good. How would I know if I had a dropped metatarsal? You’ll feel pain at the top of your metatarsal, right where it meets the base of the toe. It may feel like there’s a small pebble there and you may notice a callus on the foot pad there. The best way to get an accurate diagnosis, though, is to see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900).

How do you deal with this dropped metatarsal? In most cases, it is treated conservatively. A podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) would likely recommend custom-fit orthotics to take pressure off the dropped metatarsal and help the other metatarsals take some of the load, as they should. Anti-inflammatories and ice can help reduce pain and swelling. Physical therapy can address foot mechanics that are causing the problem.

If conservative treatment doesn’t work, then surgery might be necessary. This would usually involve either shortening or lengthening the metatarsal that doesn’t match up with the others. Recovery from surgery would take about three to four months, with time spent first on crutches and then in a walking boot.



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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.