It has been well documented within this blog that I am not a big fan of a certain New York baseball team and still harbor allegiances toward a certain Boston team that shall remain nameless.  However, word is out that Derek Jeter played on despite a “bone bruise” in his left foot.  It is unclear what the full extent of his injury was, but let’s talk about what it could or might be.

One of the most common conditions I treat in my NYC podiatry office is second metatarsal stress syndrome, ormetatarsalgia, or as I like to call it “Manhattanitis”.  The metatarsal bones are the long bones of the foot, and the bones come to a point in the head of the metatarsal.  The five metatarsal heads together comprise what is commonly known as the ball of the foot, the area that can be felt on the bottom of the foot just behind the toes.  Anatomically, the second metatarsal is most often the longest and lowest of the metatarsals, and as such, a considerable amount of force is exerted on that small bone when walking, especially at the point in the gait cycle when the heel is raised and all pressure is placed on the ball of the foot.  Over time, this pressure can produce inflammation, or a bone bruise, and may even lead to a stress fracture.  Of course this is not to be confused with a neuroma- which is a painful swelling of a nerve in the ball of the foot.

So how is this treated?  Initially it is important to recognize the source of the pressure- perhaps a less than fully supportive shoe, a high heel, a certain activity, or even a loss of the natural fat pad that cushions the ball of the foot.  Conservative treatment is usually successful, and this consists of lifestyle or shoe modifications, including the addition of an orthotic with a metatarsal pad.  After relieving the pressure, the condition often resolves.  If these treatments fail, a cortisone injection can also help to reduce the inflammation.

And as always, to ensure a speedy recovery and prevent future pain, it’s important to pay a visit to your NYC podiatrist.  And Derek, if your “bone bruise” doesn’t recover soon, I’d be happy to help, despite your pinstripes.

See you in the office.

Dr. Ernest L. Isaacson