Morton's Neuroma

courtesy Gravitydefyer

I am very fortunate right now to be in the midst of long stretch of good running health. And almost everyday when I lace up my running shoes, I thank God that I don't struggle with Morton's Neurmoa anymore.  Never heard of it?  Most people haven't.  But my guess is that many have struggled with it, but don't know what it is.  In 2007, it plagued me for almost a year, and almost ended my running career before it even seriously got started.  Here is a look at what it is, how it feels, and what I did to fix it.

Morton's Neuroma
"Morton's neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. Morton's neuroma may feel as if you are standing on a pebble in your shoe or on a fold in your sock.  Morton's neuroma involves a thickening of the tissue around one of the nerves leading to your toes. In some cases, Morton's neuroma causes a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb.  Morton's neuroma may occur in response to irritation, injury or pressure. Common treatments for Morton's neuroma include changing footwear or using arch supports. Sometimes corticosteroid injections or surgery may be necessary." (from http://www.mayoclinic.com/)

Many doctors describe Morton's Neuroma as simply an inflamed or enlarged nerve.  The pain experience is caused by irritating the nerve and surrounding area.  In most cases it can be relieved by prolonged rest or various arch supports and orthopedics.  But in some cases, surgery may be required to repair the damaged nerve.

Looking back now, I know that the Morton's Neuroma I experienced was most likely caused by wearing shoes that were too small for running.  Many women experience this problem due to high heeled shoes that confine their toes.  I am naturally an 11-1/2 depending on the manufacturer.  But in a ill conceived effort to buy "lighter" shoes that fit my foot snugly, I often ran in 10-1/2 & 11's.  Don't ask me why ... not the best of ideas, I know.  As the toes were confined in the tight shoes, the inflamed nerve became cramped and irritated by the surrounding bones, causing severe pain.

How it felt
I first noticed the symptoms after long runs. In those days, a long run consisted of about 3 miles.  I only experienced it on my left foot, but the pain was literally crippling. Remember, this is an inflamed nerve that is being irritated.  When I bent my ring finger toe and my middle toe, or applied pressure to the outside ball of my foot, there would be a "stabbing" acute pain, like an ice-pick poking in that area.  And I literally could never walk around barefoot without experiencing this feeling. 

The pain would come and go, but at it's most intense, I would lose feeling in those two toes, and it would be constant, not just after runs.  I began to modify my stride, walking and running on the outside of my left foot, and striking almost exclusively with the heel.

Remedies
For immediate relief, I iced my foot after runs, and unfortunately took lots of ibuprofen.  But in the summer of 2008, I did a couple of things that changed my running completely that I still use to this day.

First, instead of buying shoes a little too small for my foot, I went a size bigger.  I started buying 12-1/2 & 13's depending on the manufacturer.  The larger toe box area allows my toes to spread out during running, without becoming cramped and confined.  The foot will naturally swell when running long distances, partially because of the continuous pounding, but also because gravity causes blood pool at it's lowest point ... the foot.  The larger shoes also help accommodate some of this swelling.

Secondly, I read several articles indicating that elevating the arch a little would reduce stress on the nerves between the toes.  I tried several inserts, but none did the trick.  Finally I found New Balance Pressure Relief C.  (I think they have changed the name to Pressure Relief PR).  These soft foamy insoles have an elevated pad in the middle that lifts your center arch, relieving tension on the toes.  They aren't cheap - about $40-$45, which increases the cost of a new pair of shoes.  But often I can reuse them when I get a new pair.  To this day, I don't know what I would have done without them.

I would eventually like to ween myself off any insole, for health and expense reasons, but for now they have helped me run thousands of miles and 9 marathons to date.  They literally changed my running.

I hope you've never had to endure Morton's Neuroma, it's the single most painful running injury I've experienced.  But if you have, hopefully you found this helpful!
... be great today!