Lateral plantar overloading
Sometimes called ‘lateral dumping’ – due to ‘dumping’ of weight laterally. Pain over lateral metatarsal heads from excessive pressure – may have hyperkeratosis. May have restricted fifth ray dorsiflexion. Could be due to a failure of weight flow through the foot to move from lateral to medial during propulsion eg structural or functional hallux limitus – also uncompensated forefoot or rearfoot varus.
May be presenting feature in a progressive pes cavus as a result of a neurological process.
May also be due to plantarflexed lateral metatarsals (‘metatarsal equinus’).
directed at aetiology
accommodate painful area
restore the weight transfer from lateral to medial