How should a metatarsal bar be designed to unload pressure from the 2nd MPS?

A metatarsal bar designed to unload pressure from the 2nd metatarsal phalangeal (MPS) joint should be placed in a position that effectively redistributes the weight away from the area experiencing excessive pressure. The correct choice of positioning the bar as transverse proximal to the met heads allows for pressure relief at the 2nd MPS specifically by shifting the load toward the more proximal portion of the foot rather than directly across the met heads.

When the bar is placed proximal to the met heads, it provides a mechanical advantage that helps divert pressure away from the 2nd MPS, thus decreasing pain or discomfort associated with conditions such as metatarsalgia or capsulitis. This design helps to create a more even distribution of forces across the forefoot during ambulation.

In contrast, placing the bar in other positions, such as under or distal across the met heads, would still apply pressure at the metatarsals in a way that does not effectively offload the 2nd MPS. This underscores the importance of understanding the biomechanics of foot structure and the specific requirements for offloading functionalities when designing foot orthotics. The position and contouring of a metatarsal bar are crucial for achieving optimal therapeutic