Ask the Experts: How Can I Help My Student With a Dropped Metatarsal?
May 7, 2021

A dropped metatarsal is not an uncommon injury in the dance field. The metatarsals are the bones in the foot that connect with the bones of the toes. When this joint area becomes inflamed and painful, it is called “metatarsalgia.” There can be other reasons for pain in this area, such as stress fractures or arthritis, but dropped metatarsal heads, especially at the base of the second toe, are typically involved. Some people initially describe this condition as feeling like there is a pebble in their shoe while walking. 

This condition typically comes on over weeks, or even months. There can be multiple reasons the metatarsal might drop. Excessive pronation, a longer second toe with ill-fitting dance shoes, weak intrinsic foot muscles, tightness of the Achilles tendons, and poor alignment between the pelvis and the feet are a few. 

Getting a proper diagnosis is important to make sure the discomfort at the ball of the foot isn’t coming from something else, like sesamoiditis (which would be felt under the big toe) or a neuroma (most often felt between the third and fourth toes).

Having a dropped metatarsal and still trying to dance can be challenging. It goes without saying that if dancers have pain during a relevé they need to not relevé! Once they have crossed the line into pain, they should allow the tissues time to heal without continually stressing the foot.  Spending lots of time on demi-pointe and jumping will exacerbate the problem and slow the recovery time. 

If weak foot muscles are a cause of the dropped metatarsal, then strengthening the intrinsic foot muscles will be essential during rehabilitation. Doming the foot is the traditional way to do this, by placing the foot on the ground and then drawing the base of the toes up towards the ceiling, which lifts the instep. It’s important to keep the toes long and not to bend and crunch them when lifting.

Reworking the pronation pattern can be a bit trickier. Overpronation is when the weight of the body falls too much on the big-toe side of the foot. Teachers need to encourage their students to properly maintain the arches of the foot even when they aren’t in class. The goal is always to have equal weight on the three points of the foot: the pad of the big toe, the pad of the little toes and the heel. The toes shouldn’t grip when standing, which is why flip-flops should be a no-no for someone trying to correct their pronation. 

Working in parallel will help students relearn where to balance properly on the foot. Have them walk on an imaginary balance beam, staying balanced on each foot for four counts before shifting and taking a step forward on the other foot. Or, have them stand on one foot and toss a ball between their hands for a full minute. Any single-leg balancing will be beneficial.

When they need to work in a turned-out position, have them dance far enough away from the barre that they can’t use it for balance. They will need to decrease their turnout temporarily in order to not lose their balance. This is a good thing! So often dancers pronate because they aren’t using their rotators correctly, or the pelvis isn’t fully aligned over the feet and the compensation is pronation. Let them work back to increasing their rotation, safely, with the weight aligned correctly on the feet.

Using these techniques to correct the dropped metatarsal will not only benefit their dancing, but also prevent potential future injuries. 

Subscribe to our newsletters

Sign up for any or all of these newsletters

You have Successfully Subscribed!