What Is a Metatarsal Pad — and How Do You Use It Correctly?

Metatarsal pads are one of the most effective, research-backed tools for relieving ball-of-foot pain, or metatarsalgia. Yet most people use them incorrectly — which is why they don’t get relief.

In this post, you will learn what metatarsal pads actually do, why they work, and how to place them so they offload pressure instead of adding to it.

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Why does the ball of your foot hurt?

The metatarsals are the five long bones that start in the midfoot and extend into the forefoot. Their heads form the joints where the toes connect — the area we call the ball of the foot.

During walking, the forces going through this region are enormous:

💥 Peak load through the forefoot = 1.9–3.4× your body weight

This peak force occurs just before toe-off, which explains why this area is so prone to:

• Metatarsalgia

• Calluses

• Bursitis

• Synovitis ( joint inflammation)

• Plantar plate strain (ligamentous structure that stabilizes the toe)

• Fat pad atrophy

If you haven’t already, read my blog post (or watch my YouTube episode) explaining the 3 main causes of metatarsalgia — biomechanical, neurological, and arthritic. Understanding the cause will make your treatment much more successful.

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Why Metatarsal Pads Work

One of the simplest and most effective conservative treatments for metatarsalgia is offloading the metatarsal heads using a metatarsal pad.

A metatarsal pad:

• Lifts and spreads the center three metatarsals

• Reduces localized pressure on the metatarsal heads

• Redirects force off of the ball of the foot 

• Supports the plantar plate

• Reduces pain during walking

• Helps correct toe alignment in flexible hammer toes

Most cases of metatarsalgia involve the middle three metatarsals, which is why the standard pad shape is a triangle.

If all five metatarsal heads are painful, a metatarsal bar is more appropriate because it spans the full width of the forefoot.

Met pads work best when paired with:

• Custom orthotics, or

• A shoe with a rocker sole, which reduces forefoot loading even further

They can be used alone on an insole, but biomechanics improve dramatically when paired with a custom orthotics or even an over the counter orthotic .

 

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The #1 Mistake: Putting the Pad ON the AREA OF Pain at the Ball of the Foot

Despite the name, a metatarsal pad is not placed on top of the painful area.

This is where most patients go wrong.

❌ Incorrect

Placing the pad directly under the metatarsal heads or ball of the foot  (the painful spot).
This increases pressure — causing more pain.

The only instance to apply a metatarsal pad directly on the ball is when there is an atrophied fat pad under the metatarsal head. Due to the lack of natural fat cushion here, one walks on the bones. The, a direct placement of a gel metatarsal pad would be disperse pressure and cushion..

 

✅ Correct

The pad is placed just behind the metatarsal heads — before the point of pain.

This lifts the metatarsals from underneath and redistributes pressure safely.

For proper offloading, the pad often needs to be ¼-inch thick felt. Thinner foam pads rarely provide enough lift.

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How to Place a Metatarsal Pad Correctly

Placement is precise and often requires a few adjustments. Here’s the method I teach patients:

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OPTION 1: If You Have Orthotics

If the orthotic shell ends near the ball of the foot, placement is simple:

1. Turn the orthotic over.

2. Place the widest part of the triangular pad at the very edge of the shell.

3. Adhere it to the underside of the orthotic so it doesn’t feel bulky or fold when sliding into a shoe.

The pad will feel noticeable for the first few days. That’s normal — it compresses over time and becomes more comfortable.

Common patient question:

“My orthotics already have a metatarsal pad built in. Do I need another one?”

In most cases, yes.

Built-in met pads are often too thin to provide true offloading. The ¼-inch felt metatarsal pad consistently produces much better results in clinical practice.

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OPTION 2: If You’re Applying It to a Shoe Insole

For precise placement:

1. Remove the insole from the shoe.

2. Identify the most painful metatarsal head by pressing on the ball of your foot.

3. Apply a dab of lipstick to mark the exact spot.

4. Step onto the insole — this transfers the mark.

5. Pinch the mark between your fingers (top and bottom) to confirm the exact location.

6. Place the metatarsal pad just behind the marked point, on the undersurface of the insole.

7. Reinsert the insole into your shoe.

The undersurface placement prevents:

• Edges folding when putting on the shoe 

• Bulkiness

• Shifting during wear

If the pad still feels too far forward or backward, peel and reposition — small changes make big differences.

👉 I have a YouTube episode that walks through this visually step-by-step. It’s worth watching before your first attempt.

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Final Takeaway: Metatarsal Pads Are Small but Powerful

When used correctly, metatarsal pads:

• Reduce ball-of-foot pressure immediately

• Improve push-off mechanics

• Support the plantar plate

• Reduce callus formation

• Help flexible hammer toes or claw toes  straighten

• Improve comfort during walking and standing

They are one of the simplest and most effective tools I recommend for patients with metatarsalgia.

Thanks for reading,

Melissa Gaffney, DPM

 

References:

 Metatarsal Loading During Gait-a Musculoskeletal Analysis.Al-Munajjed AA, Bischoff JE, Dharia MA, et al.

Journal of Biomechanical Engineering. 2016;138(3):4032413. doi:10.1115/1.4032413.

2.

Joint Moments and Contact Forces in the Foot During Walking.

Kim Y, Lee KM, Koo S.

Journal of Biomechanics. 2018;74:79-85. doi:10.1016/j.jbiomech.2018.04.022.

3.

Forces Acting in the Forefoot During Normal Gait--an Estimate.

Jacob HA.

Clinical Biomechanics (Bristol, Avon). 2001;16(9):783-92. doi:10.1016/s0268-0033(01)00070-5.

 

Disclaimer: This blog / DrGaffneyBestFoot.com is not Intended to diagnose treat or prevent any disease disorder or condition. It is for informational purposes only and does not constitute medical advice nor is it intended to replace medical advice.  This blog/ DrGaffneyBestFoot.com does not constitute a doctor patient relationship. See full disclaimer at  DrGaffneyBestFoot.com