Question
Hello, I am planning on joining the Royal Marine Commandos, but I have developed an injury in my right foot on the 2nd metatarsal head. I have been to see a physiotherapist, Osteopath, Podiatrist, Doctors, Hospital, I've had an X-ray, changed my footwear several times, orthotics and nothing is working! My podiatrist says that the 2nd metatarsal is a little too long and when running it drops lower than the others, causing a lot of pressure when running (especially when sprinting/running on hills).

At the moment I am using a pair of military boots, Sorbothane insoles and some soft padding under my metatarsals, only because I have not tried this combination yet. So far it seems "ok", but I have only run in them once, this pain normally comes back after 2 weeks of running, so I will have to see.

My question is, what more than I try? I want nothing more than to have a life in the military, but it doesn't seem like it will happen. I am willing to try anything to get this problem fixed. Please help. Thank you.

Answer
Hi Joe
This is a problem to which there is no easy answer.  You are in a tough position since you are already training to be a soldier.  
This problem can be surgically treated, but the post operative period requires about two months of non weight bearing and probably another two months of physical therapy.  
There are many different types of orthotics.  Your orthotic should have a deep cut out under the 2nd metatarsal.  If that does not help try to get a diabetic inserts.  These are prefabricated inserts made from a material called Plastazote, which is a material which has memory, which means that it takes the shape of your foot after a short period of use.  An active person like you should change this once every two to three months as these get flat.
Best of luck
Isaac Tabari DPM
www.footdocnyc.com

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