Where should a forefoot metatarsal rocker modification be placed on a shoe?

The forefoot metatarsal rocker modification is designed to facilitate a smoother and more efficient gait by allowing for a more natural motion during the push-off phase of walking or running. Placing the modification proximal to the metatarsal head is crucial because it helps to offload pressure from the metatarsal heads, reducing pain and discomfort for individuals with conditions such as metatarsalgia or forefoot deformities.

Positioning the modification in this way allows the rocker action to begin before the metatarsal heads come into contact with the ground, enabling the foot to roll forward smoothly without placing excessive force directly on these sensitive areas. This placement also enhances the overall function of the shoe by promoting a more natural transition from heel strike to toe-off.

In contrast, placing the rocker just at the metatarsal head would not provide the desired effect of offloading pressure, and positioning it anterior to the metatarsal head could create instability or lead to an inefficient gait. Proximal to the IP joint would not align with the intended function since it would be too far back to effectively alter the forefoot dynamics during ambulation.