Comfortable with Discomfort

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MTP Synovitis causes the balls of the feet to ache.

Sarah Farris is no stranger to feeling the burn. She hits the gym most days of the week with high-impact, high-intensity workouts. So when she started to notice an aching pain in the balls of her feet, she assumed it was just normal wear and tear.

“When you workout and you’re challenging yourself, it’s hard, and sometimes that hurts. I think because I sort of adjusted to being comfortable with being uncomfortable, I didn’t quite recognize immediately that this was more of like a pain,” she said.

And the pain didn’t stop,”It hurt to stand, it hurt to walk. My feet were really swollen on the balls of my feet and red. I would wake up in the middle of the night and they would hurt.”

Dr. Ari Kaz of the Illinois Bone & Joint Institute diagnosed Sarah Farris with MTP Synovitis. He explains, “It’s inflammation in the joint where the second toe meets the foot called the second metatarsal phalangeal joint. Often times caused by repetitive trauma to the area.”

Cortisone shots have put Sarah on the road to recovery, walking again and incorporating low-impact workouts. And she’s determined to keep progressing, “I don’t like something to defeat me; I have a hard time allowing that.”

Dr. Kaz recommends that we reexamine our expectations of what our bodies are capable of, “If pain doesn’t go away with a reasonable period of rest, then it’s probably reasonable to have somebody look at it. Deformity is also another big red flag. If the toes just don’t look like they used to, then something’s wrong. Oftentimes, also, pain at rest can often indicate to you that something is happening.”

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  • James Amis

    It is fantastic for Dr. Ari Kaz to recognize second MTP synovitis and for he and WGN to report on this very common problem. He is right on the mark and this is a diagnosis that is made way too infrequently being missed most often for Morton’s neuroma. I will add two more critical facets to this story.

    First, second MTP synovitis, while not widely known, is the primary cause of second hammer toe formation as well as the late diagnosed plantar plate rupture. Injecting cortisone, while very helpful symptomatically, it is even more critical to hammer toe prevention by reducing the swelling that destabilizes the MTP joint capsule and the supporting structures. In fact, there are those health care professionals who have come up with a curious name for second MTP synovitis of “pre-dislocation syndrome”. This name kind of reminds one of the “Beverly Hillbillies” when the doorbell rings and Jethro says to Jed, “There’s that bell again, next thing you know someone’s gonna be knockin at the front door”. All too often, in medicine, we catch a disease process too far downstream, not to mention missing an opportunity for prevention, which brings me to facet number two.

    The real cause of second MTP synovitis is the isolated gastrocnemius contracture, i.e., your calves are too tight. This places leveraged increased pressure onto the forefoot. Then, because the second metatarsal happens to be the longest and the stiffest metatarsal, these increased forefoot forces are concentrated on the second metatarsal. Step after step. day after day, you have yourself what they call an overuse injury, or second MTP synovitis.

    Manage your calf contracture and you will treat your second MTP synovitis where treatment is needed, at the source. In the near future the critical roll of calf stretching daily will be more commonly known. Till then, calf contractures silent damaging effects will rage on.

  • Brenda Tucker-Jeffries

    My mother has a problem with this. Can you tell me where to find the padded ball of the foot and toe sling apparatus that the runner was using on her foot? Thanks.

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