Tight achilles tendons cause tremendous pressure after the middle of mid stance (half way through the gait cycle) on the metatarsals leading to pain in this area. The achilles tendon is the strongest tendon in the body (able to lift 11 times full body weight), so if it is tight, it can cause major issues. A simple mantra of "metatarsal pain means achilles tightness" will help you remember in your busy day. A simple stretching handout to give the patient is a good first step. However, since this is a general rule, if the patient feels no tightness in their calf with stretching, you can stop the exercise or send them to a physical therapist for evaluation.
