Management of disorders of the forefoot and toenails associated with running

Management of forefoot problems of runners requires that one understand the basic foot types and their relation to the problems as they occur and that one evaluate the entire lower extremity. The forefoot problems have been divided into disorders of the first metatarsophalangeal joint, lesser toes, metatarsalgia, callouses, and disorders of the toenails. Specific treatment and recommendation are made for each entity. Nonoperative treatment should be used whenever possible. Minor surgical procedures are helpful, but if the deformity is so severe that major reconstruction of the forefoot is performed, the patient must realize that he or she may not be able to return to full running activity.