Why can’t I get this pebble out of my shoe?

August 16, 2011
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We all know how bad it hurts to walk around with something in our shoe. Most of us can’t tolerate more than a few steps before we stop to untie the shoe to alleviate the pain. But imagine if you looked in the shoe and were surprised to find no rock, no foreign object. Think about having to walk around all day with the feeling of a rock in your shoe, and having that pain get even worse when you walk barefoot. If you have ever felt what I am describing, you may have what is termed Pre-dislocation Syndrome.

In the foot, there are 5 long bones called metatarsals. They extend down toward the toes, where they join your toe bones to form a joint. These 5 joints make up what we call the “ball of the foot”. Around each joint is a capsule, which is a fibrous, circular covering that protects the joint and prevents dislocation of the toes. On the bottom side of the foot, the capsule becomes especially thick and strong, and it is referred to as the “plantar plate.” With increasing age, high heeled shoes, or a sudden increase in physical activity, the plantar plate can be injured. With injury, the plantar plate becomes weak and is less capable of stabilizing the joint. Instead of your toes having a solid foundation to rest, they start to partially dislocate toward the top side of your foot. This condition, known as Pre-dislocation syndrome, can give the sensation of walking around with an invisible rock in your shoe right under the ball of your foot. This phenomenon is jokingly called “Floating Toe Syndrome” since your toes start to move around uncontrollably as you walk. Although this can happen with any of the toes, it most commonly happens with the 2nd toe.

Go ahead… Look under your foot. If you see a grape-sized lump under any of your toes, and you have pain that goes away with rest, you may have this condition. Fortunately, as the name implies, the toe is not fully dislocated and can be treated to relieve the pain.

We’ll discuss next time some of the treatment options available to combat the your floating toes.

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