Metatarsal pads are used to help spread your transverse arch (the arch behind the ball of your foot, that runs across the width of your foot), promote the return of your overextended toes to their normal anatomical position, and encourage the return of your forefoot fat pad to its rightful position supporting your metatarsal heads. Your metatarsals are the long, thin bones in your mid-foot. The heads of your metatarsals are at the ball of your foot, and they connect to the base of your toes. Metatarsal pads help properly realign your metatarsal heads and the fat pad that’s underneath them. This, in turn, can help straighten and realign your toes, especially when your metatarsal pads are used in conjunction with our toe-spacing product (Correct Toes).
The conventional footwear features of heel elevation, toe spring, and toe taper can
negatively affect your foot over time. After many years of weight-bearing activity in shoes possessing these design characteristics, your feet become shaped like the shoes you wear. Your toes become chronically overextended (pointed upward) and tapered toward your foot’s midline. The muscles under your foot, your flexors, become excessively stretched and weakened, while your extensors, on top of your foot, become too tight. In turn, your forefoot’s fat pad, which normally provides cushioning for your metatarsal heads and the nerves between them, becomes displaced too far forward. The bones and nerves in this area are then relatively unpadded and therefore vulnerable. This foot configuration can lead to a host of problems, including, but not limited to, Morton’s neuroma, sesamoiditis, and plantar fasciosis, or more simply: pain in the ball of your foot, heel, or both.
Metatarsal pads, when properly placed within a completely flat shoe with a sufficiently wide toe box, can help undo muscle imbalance in your foot. Metatarsal pads help reconfigure your foot to the position that nature intended; that is, with splayed metatarsal heads, splayed toes, and a fat pad located directly underneath the fragile bones and nerves in the ball of your foot. Numerous foot and lower extremity problems can be prevented or reversed by restoring your natural foot anatomy and function.
It’s important to place your metatarsal pads correctly in your shoes. Please see our document on the proper placement of metatarsal pads. Improper placement of pads is uncomfortable and could possibly worsen your foot condition. Also, as with Correct Toes, it’s important to use metatarsal pads in shoes that are completely flat (i.e have no heel elevation, no toe spring, and no padding under your arch) and widest at the ends of your toes (not just at the ball). Finding such shoes can be challenging. Please see our list of healthy footwear options.
Bottom of pad contains a sticky adhesive for easy placing. Click here for more detailed information on placing metatarsal pads.
Raynaud’s is a health problem that affects the arteries. Raynaud’s sometimes is called a disease, phenomenon, or syndrome, and it’s characterized by brief bouts of vasospasm, or the sudden narrowing of a blood vessel, which results in a reduced flow rate through that vessel. Arterial vasospasm primarily reduces blood flow to the fingers and toes. Though most people with Raynaud’s experience reduced blood flow to the fingers, a significant number of people with this condition (40%) also experience reduced blood flow to the toes. In rare cases, this condition may affect blood flow to the nose, ears, nipples, and lips.
Raynaud’s attacks limit the amount of blood that reaches the skin in affected areas, causing these areas to turn white and blue. When the involved blood vessels do eventually relax, normal blood flow to the affected areas resumes and the skin turns red and throbs, tingles, burns, or feels numb. In only the most severe cases does Raynaud’s cause sores or tissue death. A couple of key triggers—cold weather and stress—are known for this health problem, though in many cases, the true underlying cause of Raynaud’s is unknown. What is known is that people living in colder climates develop this health problem more frequently than those living in warmer climates.
There are two principle types of Raynaud’s: Primary and secondary. Primary Raynaud’s, also known as Raynaud’s disease, is the most common type of the disorder, and it occurs without the presence of any underlying health problem that could induce vasospasm. Secondary Raynaud’s, also called Raynaud’s phenomenon, is less common than primary Raynaud’s and is caused by an underlying medical condition. Raynaud’s phenomenon usually is the more serious of the two types of Raynaud’s. Most people who develop Raynaud’s phenomenon do so around the age of 40, whereas those who have Raynaud’s disease develop symptoms much earlier in life.
“Raynaud’s attacks” can be triggered by cold temperatures or stress in people who have primary or secondary Raynaud’s. Even relatively mild or brief temperature alterations can provoke a Raynaud’s attack. A person with Raynaud’s who removes something from the freezer or who is exposed to temperatures below 60 degrees F may notice his or her fingers turning blue shortly thereafter. Most people who have Raynaud’s suffer no lasting tissue damage or disability, though people who have severe versions of this health problem may develop gangrene (tissue death) following repeated or prolonged Raynaud’s bouts. Approximately 5 percent of people in the United States have some form of Raynaud’s.
Causes and Symptoms
Physicians and researchers do not completely understand why Raynaud’s attacks occur, but, as previously mentioned, cold temperatures and stress are the two main triggers causing blood vessels in the hands and feet to overreact. Cold temperatures cause the extremities to lose heat, and the body minimizes blood supply to the fingers and toes to keep the core temperature stable. This response is exaggerated in people who have Raynaud’s. Stress provokes a similar kind of reaction, and its effects are, again, exaggerated in people who have Raynaud’s.
There are a number of conditions that may cause secondary Raynaud’s, including scleroderma, lupus, rheumatoid arthritis, Sjogren’s syndrome, arterial diseases (e.g., Buerger’s disease), carpal tunnel syndrome, smoking, injuries (e.g., wrist fractures, frostbite, etc.), certain medications, chemical exposure, and thyroid gland disorders. Another possible cause of secondary Raynaud’s is overuse injuries. Workers who use vibrating equipment for prolonged periods may develop a Raynaud’s phenomenon known as vibration white finger.
Raynaud’s signs and symptoms depend on several factors, including frequency, duration, and severity of the vasospasms. Some of the most common signs and symptoms of this health problem, however, include:
Cold fingers and toes
Changing skin color in the affected area in response to cold or stress
Numbness, stinging, or a prickly feeling with exposure to warmth or decreased stress
Raynaud’s signs and symptoms usually follow this pattern: The skin in the affected area turns white before eventually turning blue and feeling cold and numb. Most people also experience a blunted sense of touch. Once the involved blood vessels relax and circulation to the fingers and toes improves, the affected areas may turn red, and they may tingle, throb, or swell. The order of the skin color changes is not always the same between people, and some people who have Raynaud’s may not experience all three colors (white, red, and blue) during an attack.
In some cases, a person who has Raynaud’s may experience symptoms in just one or two fingers or toes, and the location of symptoms may even vary from one attack to the next in the same individual. A Raynaud’s attack can last anywhere from under a minute to multiple hours.
Minor lifestyle changes, self-care activities, and prevention techniques can all help manage this condition. Helpful conservative approaches include:
Quitting smoking: Smoking causes blood vessels to narrow, which in turn lowers skin temperature. Even secondhand smoke can cause problems in people who have Raynaud’s.
Participating in exercise regularly: Raynaud’s sufferers, especially people who have primary Raynaud’s, may benefit from exercise, as physical activity boosts circulation.
Learning healthy ways to manage your stress: Because stress is a key trigger for Raynaud’s attacks, any action taken to reduce stress levels may help manage this condition. Avoiding stressful situations, meditating, practicing breathing exercises, and spending more time in nature are just a few ways to reduce stress levels.
Avoiding caffeine: Caffeine causes blood vessel constriction and can exacerbate the signs and symptoms of Raynaud’s.
Caring for your hands and feet: A person who has Raynaud’s should take special care of his or her hands and feet. Barefoot walking can be problematic for Raynaud’s sufferers and should be avoided. An individual with Raynaud’s should also avoid wearing constricting footwear, rings, tight wristbands and anything else that can compress blood vessels in the hands and feet.
Correct Toes may be helpful in treating Raynaud’s. Correct Toes toe spacers help spread the toes, which helps reduce compression forces on the small arteries that branch at the ball of the foot and deliver blood to the toes. Note however, that a person with reduced sensation in the feet and toes should avoid using Correct Toes until he or she speaks with a doctor.
Avoiding mechanical triggers: Certain workplace tools, especially tools that vibrate, can provoke Raynaud’s attacks. A person with Raynaud’s should consider avoiding these tools to decrease the frequency of Raynaud’s attacks.
To treat an acute Raynaud’s attack, it’s important to warm the hands, feet, or other affected areas quickly. The following can be done to help warm the fingers and toes:
Relocate to a place of greater warmth
Put the hands under the armpits
Wiggle the fingers and toes
Perform arm windmills
Place the fingers or toes under warm (not hot) water
Massage the affected areas
If a Raynaud’s attack is triggered by stress, a person can remove himself or herself from the stressful situation and practice relaxation techniques to help resolve the attack. Biofeedback—a treatment technique that involves relaxation, visualization and other cognitive control methods—can affect body temperature and help treat Raynaud’s attacks too, especially when combined with the warm water treatment.
In some cases, especially with the more severe forms of Raynaud’s, aggressive treatment approaches may be required to decrease the frequency and severity of attacks, protect against tissue damage, and address the underlying disease causing Raynaud’s. A doctor may prescribe medications to help dilate the blood vessels and boost blood flow to the extremities.
Dear Dr. Ray McClanahan, I have never met you but I want to thank you. I’m a post-collegiate distance runner who wishes to continue his career as a competitive distance runner. I enjoy running anything from the mile to the half marathon […]. I was constantly broken down in college and running in what many would consider “pronation control” shoes because I was under the impression that I needed support. The past year and a half I’ve made a very good transition into more minimal based shoes, but recently have been running into forefoot/toe pain. Then I discovered your website. I now own a pair of Correct Toes, metatarsal pads, and [minimalist footwear]. I’ve been walking in them and running a little bit. The pain is gradually going away and my feet are feeling healthier and stronger. […] I think it’s safe to say that your ideas on footwear and foot health are very progressive and forward thinking. You must continue doing what you’re doing and get the good word out. Good ideas will always be the best defense against bad ones. And your ideas are clearly good – very good.
— D.S., Clark, NJ
Click here to read more Correct Toes testimonials!
New Year’s has come and gone, but the important work of 2013 has only just begun. This year, consider making lasting foot health your new year’s resolution! Attention and time given to natural foot health concepts and activities can yield profound foot health benefits, both for foot injury prevention and improved quality of life. Caring for your feet and allowing them to function the way nature intended can keep you pain-free and performing those activities you love most. In most cases, the answer to long-term natural foot health is simple and involves removing the impediments to optimal foot functioning and remaining disciplined in your natural foot care routine. Here are a few simple and effective ways to care for your feet this new year and beyond:
Wear Healthy Shoes as Much as Possible
Resolve to wear only healthy shoes as much as possible in 2013. This simple strategy will help you treat or prevent some of the most common foot, toe, and lower extremity problems, including bunions, hammertoes, plantar fasciosis, interdigital neuromas, and ingrown toenails. Healthy shoes allow your feet and toes to function the way nature intended; that is, with toes splayed and heel and forefoot on a level plane. Healthy shoes are shoes that don’t get in the way of your feet or alter your gait in any way. Using healthy shoes is especially important for weight-bearing activities, including weight-bearing activities in both casual and athletic situations. Wearing conventional footwear (with its many injurious design features) for running and walking can accelerate toe deformities and lead to chronic foot and toe problems.
Resolve to Make Wise Footwear Purchases
To ensure natural foot health in the new year, make your next footwear purchase one that incorporates all the desired design features we typically look for in shoes. Key design features to consider when shopping for new footwear are degree of heel elevation and toe spring, toe box width, and sole flexibility. An ideal shoe has no heel elevation or toe spring, only a completely flat sole from heel to toe. This flat platform allows your principle foot arch to act as it is supposed to and helps enable natural arch support. A sufficiently wide toe box is widest at the ends of your toes and allows your toes to splay optimally when standing, walking, or running. A shoe with a flexible sole improves your tactile sensation of the ground and helps strengthen your intrinsic, or internal, foot muscles. You should be able to easily fold the shoe in half or twist its sole with little restriction.
Wear Correct Toes Every Day
Wearing your Correct Toes every day is an excellent way to achieve lasting foot and toe health in 2013. Correct Toes creates space between your toes and realigns your toes to their normal anatomical position. In this optimal position, your toes are free to perform as they were intended, and you are less likely to experience the foot and toe problems that plague so many shod, or shoe-wearing, individuals. It’s important to transition into Correct Toes use slowly, as it can take some time for your foot to adapt to this new toe orientation. It’s also important that you use your Correct Toes in shoes that possess sufficiently wide toe boxes. You can use your Correct Toes on your bare feet, over toe socks, or within conventional socks. Some people use Correct Toes as a night splint to help treat bunions and other foot and toe problems.
Perform Relevant Foot Stretches Regularly
Certain foot stretches can enhance your foot health, especially if you perform them on a regular basis, according to your healthcare practitioner’s instructions. We find several foot and toe stretches particularly helpful, including the toe extensor stretch. This stretch helps lengthen tight toe extensor muscles and tendons. Tight toe extensors can cause a variety of foot and toe problems, and the toe extensor stretch helps balance the pull of toe extensor and flexor tendons on your toes. Other helpful foot stretches or exercises include the bunion stretch and the hacky sack grab exercise, both of which can be easily performed at home.
Be Active & SMART!
Being physically active in 2013 is an excellent way to ensure natural foot health, especially if you choose to be active in footwear that allows you to incorporate Correct Toes and respects nature’s brilliant foot design. We encourage you to select an activity that you find truly enjoyable to help put your feet and toes to good use. We also encourage you to set fitness goals that are SMART—Specific, Measurable, Attainable, Realistic, and Time-Bound (e.g., “I want to be able to run 5 miles in 40 minutes by May 15.”). A SMART approach to fitness or health goals keeps you engaged in the process of health attainment, and it ensures that you experience frequent successes to keep you motivated.
Resolve to make natural foot health a priority in 2013. Visit our website to learn more about the strategies to do just this. May 2013 bring you all lasting foot and toe health!
Have you ever noticed the foot of a child? Particularly a child who has just been born? The child will have a forefoot that is wider than the rest of the foot. Meaning, the tips of the toes are wider than the ball of the foot and there are natural spaces in between the toes. Unfortunately, we fail to recognize the importance of these natural findings and begin to cripple the foot of the child by placing the child’s feet into shoes that push the toes into an unnatural alignment. It is practically impossible to find a pair of shoes or boots that are manufactured wider at the end of the toes than at the ball of the foot. On the contrary, almost all shoes and boots, including athletic models, squeeze the toes into a triangular shape that compromises their natural grasping and balancing functions. We accept this because we have been doing it since people began to wear shoes, but we also accept it because most people do not fully understand the importance of the function of the toes, including many doctors entrusted in the care of them.
The toes are critical for our sense of balance, which is very important when we go onto our toes just before we toe off in the part of walking and running that we call propulsion. When our toes are not properly spaced and grasping the ground, our legs and upper bodies are forced to make compensations for the instability of our toes and our gait is less balanced and less efficient. Most shoe wearing people begin to lose the function of their toes early in life because almost all shoes push the toes together and hold them above the ground surface. We make compensations for our faulty walking, but the cost of these compensations is foot deformity, leg and back pain and abnormal gait. Thus, it makes sense to find shoes that allow an individual to spread their toes and have the ends of their toes next to the ground. Unfortunately, there are few such shoes available, and furthermore most shoes have an elevated heel which further compounds the imbalance within the toes of the foot. A good example of a shoe that would be healthy is a shoe that is shaped like a Birkenstock sandal.
So, how do we go about the task of finding shoes that give our toes the room they need? I do not have much hope that shoe and boot manufacturers are going to make any radical changes, since fashion and cosmetics have been the traditional motivators in their market.
Consequently, the best recommendation is to find a shoe store that specializes in wide shoes and removable insoles. To see if the toebox will have adequate room for your toes, it is recommended that you find shoes with removable insoles and stand on them with the socks that you intend to wear, preferably with your toes spread. If no part of your foot expands beyond the insole, especially your toes, that shoe may work for your feet. Unfortunately even amongst wide brands you will find that most toeboxes are more tapered, narrow and pointed than the average foot. So why do we tolerate it? We tolerate it because we are not educated about the potential problems associated with this bad positioning of our toes and the front of our feet. And we tolerate it because that is the way most shoes are built.
These problems occur very rarely in cultures where shoes are not worn, but they are exceedingly common in our shoe wearing culture.
It is interesting to note that the above foot problems include most of the common foot problems that are treated by medical professionals, yet treatment most often does not include education as to how to prevent these problems once they have been identified. Worse still, reconstructive surgery is often recommended for some of these conditions, without mention of need to modify the types and shapes of shoes that are worn.
As more Americans turn to walking for fitness, fun, and the pursuit of health, opportunities to participate increase every year. Walkers benefit from relay events specifically designed for them. Racewalking opportunities challenge those who wish to compete and find their own personal best. There are better coaching resources, seminars on walking, and multiple opportunities to connect with other walkers for group walks.
Walkers also find many exciting opportunities to get off the concrete and blacktop and pursue walking on more natural and yielding surfaces, such as sand, grass, gravel, snow, and mud. The Wildwood Trail in Northwest Portland boasts some of the finest mud around for a few months of the year before turning to hard-packed dirt, making for some amazing and ever-changing walking terrain.
As walkers venture off-road, they often experience a totally different physical walking experience than they have previously had on a flat, hard surface. They are challenged by walking up, down, and along hillsides. They find themselves needing to look down in search of roots, rocks, and uneven areas. They find a greater need for their bodies to accommodate different ground surfaces.This is where I come in. I am the keeper and preserver of the foot and ankle joints of walkers and runners. I am the sports podiatrist. I realize the crucial role played by the multiple joints of the walker’s feet and ankles that enables the walker to traverse undulating ground while keeping the body upright. I am keenly aware of how strong, adaptable feet and ankles can allow a walker’s entire body weight to pass over the talus bone painlessly, even when carrying a heavy pack.
This is accomplished by allowing the foot and ankle to do what they do best: adapt to changing ground and relay tactile details to the brain. The brain uses this information to activate the muscles of the body in response to what was sensed by the foot, ankle, and lower leg. When this happens as it should, walking is accomplished and perceived in an efficient and flowing manner.
Unfortunately, most Americans have not had the opportunity to develop strength and adaptability in their feet and ankles over their lifetimes. Exacerbating the problem is the current tendency of footwear retailers to promote certain technologies built into a shoe or boot, such as motion-controlling or anti-pronation features. Some Medical professionals also favor prescribing footbeds, orthotics, and arch supports. The philosophy of the anti-pronation crowd implies that there are defects in the adapting and sensing mechanisms of the feet and ankles of walkers, and that these defects can be corrected by applying some method of partial immobilization built or placed into the footwear of walkers.
In contrast to this common view, it’s my belief the human body was specifically designed for the activity of walking and will involuntarily develop strength and adaptability of the feet and ankles, except under certain select circumstances. The most significant of these circumstances is the use of footwear when walking. Close second, in severity of negative long-term consequences, is the lack of awareness that most footwear designed for walking is the most likely reason for injury experienced during extended walking. Because of this lack of awareness, footwear is not considered in the differential diagnosis of a walking injury.
Many walkers who have sought consultation with us have discovered the benefits of transitioning to footwear that enables their feet and ankles to function as nature intended them to. That is, to be strong, flexible, and perceptive of the ground surface being walked upon.
Correct Toes eliminate the need for conventional orthotics in most people by enabling your foot arch (i.e., your medial longitudinal arch) to support itself. (Read more about natural arch support). In general, we DO NOT recommend wearing Correct Toes in combination with orthotics; we instead recommend weaning yourself off orthotics—slowly and progressively—when introducing Correct Toes. Correct Toes are, by definition, an orthotic, though conventional custom orthotics are placed under your foot arch (instead of between your toes) and attempt to alter foot position by using an unnatural methodology (i.e., by propping up your foot arch).
In other words, custom arch orthotics are not natural in any way. In fact, they violate the natural anatomy of your foot’s arches by artificially lifting them and placing material under them in a manner never seen in nature or in human-made structures, such as arch bridges. They may, initially, help gain a more natural foot position, but they do so artificially and the results are temporary. Our toe orthotic, Correct Toes, supports your foot’s arches in the exact manner nature intended, by placing your toes in their ideal natural alignment. So here we have two different types of orthotics attempting to do the same thing: one violates the natural anatomy of the foot, the other provides natural alignment to the foot and toes, and thus balance and support. Correct Toes are particularly effective in enabling optimal foot health when used in combination with a completely flat shoe surface (i.e., when they are worn in a shoe that possesses no heel elevation, toe spring, or motion control features).
While most people do not need orthotics if they use Correct Toes in footwear that allows proper toe splay, there are a few rare individuals who, even with Correct Toes and proper shoes, may not be able to restore their own arch structures simply by using their foot naturally. These few individuals may, in fact, benefit from Correct Toes AND orthotics. In even rarer cases, where the combination of Correct Toes and orthotics does not restore foot arch structures, a surgical procedure on the ankle may be warranted. Of course, Correct Toes should be worn after this surgery to help maintain proper toe and foot alignment.
Click here to get more information about Correct Toes and for answers to more frequently asked questions.