Side Angle Yoga Pose
• It is rarely necessary to stop training for this problem, unless one cannot maintain a normal stride.
• Adding a rest day after symptoms can speed healing.
• If the pain persists for more than a few weeks and is ignored, there is probably a structural foot problem or one is suffering from another injury. It is possible for metatarsalgia to develop into a more aggravated condition such as a neuroma or synovitis due to continued stressful training.
METATARSAL PHALANGEAL SYNOVITIS
• ALSO KNOWN AS CAPSULITIS, PRE-DISLOCATION SYNDROME, PLANTAR PLATE INJURY, OR METATARSALGIA OF THE FRONT OF THE FOOT AT THE SECOND OR THIRD TOE JOINT
• Inside of the second (or much less commonly third) metatarsal phalangeal joint.
• Pain at the connection of the toe to the foot usually on the bottom or deep inside, but occasionally on top of the joint.
• It is confused with a neuroma, but neuroma pain is between the metatarsals.
• The joint will often swell and feel thicker than the joints on the non-injured foot.
• Achy constant pain that grows in intensity with use, or intensifies if stepping on a rock or bump.
• Pain increases with yoga/walking, but sometimes will “numb out” during the activity only to return later. Numbing does not mean that the injury is going away. The area is significantly irritated and it is risky to push through this.
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• The pain is localized at the base of the joint of the 2nd or 3rd toe, but may extend into the toe and can even produce progressive numb toe.
• The initial damage occurs within the joint surrounding the metatarsal head connection to the base of the proximal phalanx of the toe.
• It can start as a simple impact injury from an object on the ground, but it is most commonly a gradual repetitive motion injury because of the improper movement of the toe connection.
• There is a complex apparatus composed of ligaments, tendons, and joint capsule in this area. When any of these tissues are damaged, swelling occurs within the joint producing more damage as the toe bends repeatedly. In many ways this little joint is more complicated than an ankle joint.
• Permanent angulation of the toe toward the big toe is common even after the injury heals because of damage to the joint tissues on the lateral side.
• There is a firm tissue on the bottom of the joint called the “plantar plate” that can become irritated and require an extended healing period, with a tendency to reoccur. In some cases surgery is required.
• There is a variant of this injury in which the joint experiences little inflammation inside, but it is quite sore at the front where it becomes the bottom of the toe. This is sometimes called flexor tendinitis because it involves the long toe tendon that pulls the toe downward.
• In advanced cases the supporting structures become so damaged that the toe dislocates and pops up above the metatarsal. Surgery is then required.
• The swelling that causes the joint to feel enlarged (like standing on a marble) is from synovial fluid which irrigates the joints. The body produces an excess amount when there is inflammation in a joint. The reduction of this fluid is an important part of the healing process.