Metatarsalgia (mid-foot pain)

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Metatarsalgia (mid-foot pain)

When the feet are overtaxed, they react with pain when standing and walking. Women, in particular, suffer frequent pain in the front part of the foot. Because of the complex interaction of bones, muscles, nerves and tendons, it is often difficult to determine a single cause.
A natural rollover of the foot is possible in the kyBoot/on the kyBounder and the foot can recover from the pain. The muscles and tendons are gently stretched and strengthened, and the joints mobilized.


Metatarsalgia is a general medical term for pain that arises in the mid-foot area, often related to loading when the second to the fifth metatarsals (toes and related mid-foot bones) are affected. Disorders involving the first metatarsal are dealt with separately.

For a differential diagnosis, a distinction must be made between primary metatarsalgia with a local cause in the mid-foot area and secondary metatarsalgia associated with systematic symptoms (rheumatism, gout, arterial circulation disorders).


Possible causes:

  • foot malpositions or weak foot musculature: ‘Flatfoot,' ‘forefoot muscle weakness,' ‘flattened transverse arch,' ‘splayfoot.'
  • Splayfoot deformity is clearly the most common in practice and can trigger various disorders in bones, joints, and soft tissue.
  • Disorders of the bones of the middle and front of the foot, the toe joints, the soft tissue and the toenails
  • weak connective tissue
  • high heels
  • narrow, sturdy shoes
  • severe loading
  • being significantly overweight
  • neurological: ‘Morton’s neuroma,' ‘forefoot neuralgia.'

Possible causes of front-foot/mid-foot pain in the kyBoot:

  • Initial reactions in the kyBoot: Overtaxation of the forefoot musculature or the transverse arch
  • muscle tension: ‘clenching the toes’ (usually done unconsciously to stabilize the foot)

Long-term consequences

If no active therapy is undertaken to correct the foot malposition, it will become increasingly pronounced, leading to pain and complaints in other joints, such as the knees or hips, or the back.

Conventional therapy

  • orthopedic shoes with a broad toe box
  • special insoles
  • truss pads (elevation at the forefoot built into the shoe)
  • injection of a local anesthetic and cortisone treatment
  • regular foot physiotherapy exercises
  • therapy
  • operation

Foot malpositions are usually treated conventionally with passive insoles, which sometimes improve the symptoms in the short term, but weaken the foot musculature and make the foot malposition more pronounced in the long term.

The kybun principle of operation – being proactive

The primary purpose of the kyBoot is to shift the forces that would otherwise be exerted on the back, hips, and knees onto the feet. This relieves the back and the joints and relaxes tense muscles and increases the load on the feet. This is the correct thing to do because the primary forces should be on the feet when standing and walking.
In the kyBoot, your foot can move naturally in all directions, training the core, stabilizing musculature of each foot equally and improving foot mobility. The foot becomes more robust and stable, and foot malpositions that have arisen due to weak musculature are improved or corrected completely.

Only active, frequent foot training can counteract front-foot/mid-foot pain in the long term. Insoles provide only short-term improvement because they passively support the feet. They do not strengthen the feet; on the contrary, they continuously weaken them while overtaxing other joints.

Initial reactions

Special initial reactions with metatarsalgia:

With mid-foot problems, you may experience increased pain if your transverse arch is flattened (as it is with splayfoot) and you wear orthopedic, supporting insoles in your conventional shoes. If this is the case, we recommend that you put thin, stiff front-foot insoles (available from shoe shops) into your kyBoot so that some of the softness is taken from the kyBoot sole.

Click here for the general initial reactions experienced by kyBounder and kyBoot beginners: Initial reactions

kybun exercises

For information about the special kyBoot exercises or the basic kyBounder exercises, please click here: kybun exercises

Application tips

  • For those with greatly flattened transverse arches, we recommend using stiff, thin insoles for the forefoot area in the kyBoot if pain develops. This reduces the softness of the kyBoot sole slightly and gives the front of your foot a little added support.
  • If the hard insole for the front of the foot from a shoe shop does not improve things, we recommend alternating between wearing the kyBoot and ‘normal, hard shoes with insoles’ as your ‘active shoe.' This allows your foot to recover from active training in the kyBoot before front-foot pain develops.
  • Be sure to maintain an upright body posture and foot position in the kyBoot/on the kyBounder. Look straight ahead and correct any lateral/medial rolling in the kyBoot.
  • Your feet should be able to move freely in the kyBoot! Shoe size and model can make a critical difference. It is normal to feel less stable in the kyBoot than you would in ‘normal’ shoes at first. Take your time when trying the kyBoot on; your local kybun specialists will be pleased to assist you.
    Relax your toes in the kyBoot/on the kyBounder (it is common to unconsciously clench them)
  • Roll forward naturally over the entire foot (from the heel to the push-off with the big toe).
  • Avoid taking steps that are too long so as to ensure that the joints bear a correct axial load, which is less taxing. This also makes it easier to balance on the kyBoot sole.
  • Some people feel too unstable in the kyBoot. In this case, we advise you to try various kyBoot models; some models have a higher cut and provide more stability. We also recommend the second-generation sole to these customers. It is a little wider in the mid-foot area, making you feel safer while walking (ask for advice in a specialized kybun shop).
  • If you still feel too unsafe walking in the kyBoot, we advise using the kyBounder. The kyBounder is available in three different thicknesses. This allows you to choose the thickness that is most comfortable for you (the thicker, the less stable, and the more intensive the training).
    You can also hold on to a fixed object if you need additional support when using the kyBounder.

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