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Constriction on ball of foot.

by John
(Hampshire. England)

Whatever shoes I where, on my right foot it always feels that my sock is crumpled up behind my toes when in fact the sock is nice fitting. Thinner socks have a lesser effect. No socks still imparts the same sensation. Barefoot feels as if there is a hardening under the foot pad. Though inspection feels all is ok.

My left foot is unaffected.
I am 67 years, male. Average weight and in good health. Fairly active, playing golf 1 or 2 times weekly.
Thanks for any ideas. John.

RESPONSE

Hi John,

Naturally, without being able to actually examine you I have no idea what is causing your particular problem but I will discuss with you a reasonably common complaint of that feeling of a sock rolled up under the foot, where in reality there is no rolled up sock.
The number one cause for such a complaint is a Morton's neuroma. A neuroma is essentially an enlarged nerve that is being constantly irritated where it passes between two metatarsal bones. The classic neuroma is between the third and fourth metatarsal heads although a neuroma can occur in the other interspaces between metatarsal heads.
As the nerve is irritated it begins to enlarge from the chronic irritation. In most cases it will begin to cause neurological symptoms like burning, tingling, numbness and even outright pain that starts in the area you describe. For most people the neurological sensations will even travel into the toes that are innervated by the nerve in questions. Sometimes, the symptoms will travel backward into the foot as well.
It appears from your narrative that you are not having any of these symptoms, but what you may be experiencing is an annoying sensation just behind the toes which is just from the nerve being enlarged, mildly inflamed. It is the inflammation that is causing the feeling of a sock being rolled up. This too, would explain the hard feeling you experience when walking on floors barefoot.
Now, that is not the only condition that will cause those symptoms.
Any swelling in the area may cause the same symptoms. Capsulitis would be the next condition that I would look into. This is essentially an over stretching on the bottom of the foot of the ligament that attaches the metatarsal bone to the base of the toe. Over stretching leads to inflammation and this inflammation results in the foot feeling like the sock is rolled up.
Perhaps less frequently occurring are conditions like such as a cyst in the forefoot which may be growing and even though it does not hurt could give you the feeling of a rolled up sock.
In addition, as we age, the one part of the body where we lose fat is the ball of the foot. Fat is supposed to cushion our gait but once the fat has disappeared we start walking on the head of the metatarsals and you could be experiencing a reaction to excessive stress on the bone which may be causing an inflammatory reaction and again, your rolled up sock symptoms.
So, as you can see there are a few conditions or situations which may cause your symptoms.
If you really want to know what is going on, I would suggest you consult with a foot specialist in your area.


Marc Mitnick DPM
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