Metatarsalgia (Pain under the transverse arch).

Brian Mulligan: “If pain under the heads of the middle metatarsals can be reproduced with toe flexion or extension, this could be due to a metatarsal head positional fault and a “MWM” should be tried.

With the patient’s foot on the plinth stand distal and grasp the head of say the third metatarsal between the soft pads of your thumb and index finger. Your other thumb and index finger grasps the head of the adjacent second. Now glide and hold the third down on the second while the patient flexes his toes. If painful, glide the second down on the third.

When painless, repeat six to ten times and then have the patient flex his toes without assistance to reassess. After several sets he should feel much better. We would follow this therapy with corrective exercises.”

Source:  Manual Therapy, NAGS, SNAGS, MWMS etc. by Brian R Mulligan, 7th edition.