Kinetic Musings On Metatarsal Domes
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Kinetic Musings On Metatarsal Domes
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This podcast muses on the kinetic effects of probably the most ubiquitous foot orthotic prescription item - the metatarsal dome. While metatarsal domes are considered a low-risk solution for forefoot pain, they function as significant mechanical interventions rather than simple metatarsal head spreaders and pressure reducuers. By shifting plantar pressure away from the metatarsal heads, these inserts create a functional fulcrum shift that alters how the foot handles weight during movement. This redistribution effectively bypasses the metatarsophalangeal joints, reducing the external dorsiflexion forces acting on the distal forefoot and the ankle. Consequently, the effective lever arm effect of the foot is shortened, which can change gait timing and force more proximal joints like the knee and hip to compensate in some patients. Clinicians must recognise that even though these devices may successfully alleviate local symptoms in the forefoot, they may exert system-level kinetic consequences that fundamentally transform walking mechanics.