The forefoot: A user’s guide

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The forefoot consists of three distinct parts: five metatarsal bones (running from the arch to the toes) which act as shock absorbers and also play a crucial role in propulsion at toe-off; the toes; and two sesamoid bones, which protect tendons, absorb pressure on landing and act as leverage for the toe flexor on push-off.

Improve your run: Big toe mobility

Why it matters: ‘Fully extending through the big toe gains vital power at every step,’ says podiatrist Simon Miles. Lack of mobility means increased pronation and reduced efficiency. ‘When the weight travelling through the foot moves from the big toe to the next joint along, it creates inefficient biomechanics because this toe is not designed to propel us like the first toe is,’ explains Miles. ‘Lack of mobility can also cause osteoarthritic changes, leading to deformities and loss of function.’

Red flags: ‘You should be able to lift your big toe to 60 degrees when standing,’ says physiotherapist Scott Mitchell. If you can’t, you may need to work on mobility. Another indication of reduced mobility is hard skin under the second metatarsal head, says Miles.

Maximise performance: ‘Try a calf stretch with your toe extended,’ says physiotherapist Noel Thatcher. ‘Hold for 30 seconds, then repeat on the other side. Barefoot exercises on uneven surfaces such as grass or sand also benefit big-toe strength, stability and proprioception [your sense of your body’s position and orientation].’

Injury risk: Metatarsalgia

What is it? ‘A generic term referring to pain on the ball of the foot, often described as a “bruised feeling”,’ says Thatcher.

Symptoms: Burning, stabbing or aching pain beneath the toes – usually worst at the second toe.

Cause: Thatcher says this is caused by a combination of the following: increased training, particularly on hard surfaces; poorly cushioned shoes; rigid, supinated foot type; or anything that restricts foot movement, such as tight lacing.

Beat it: Take a load off for a few days after experiencing symptoms – either by taking a complete break or switching to softer surfaces. Treat soreness with RICE (rest, ice, compress, elevate) for 24 hours, and seek medical help if pain persists. 

Prehab

Try these exercises:

1. Plantar sling strengthener: Loop a resistance band around a desk leg. Put the arch of your foot in the loop, then pull the band away from you, then back, 10 times. Replace your right foot with your left, and pull towards you. Repeat facing the other way.

2. Arch strengthener: Pick up a marble with your big toe, hold for five seconds, release and repeat working your way from big to little toe.