Two years ago, while training for IMH I developed a sharp pain on the ball of my foot between the second and third toe. The pain was worse while running on ANYTHING other than flat concrete, ie. dirt, sand, grass, up and down hills. Research indicated that it was probably Morton’s Neuroma, an inflamation of the nerve between the toe bones. To make a really long story, just kind of long, I only ran on flat concrete, tried DMSO, and put metatarsal pads in my shoes. This did not alleviate the pain completely, but allowed me to continue running. I was finally able to see a Dr. and get orthodics through my insurance co. but the Dr. had little experience in athletic orthodics, and the ones perscribed to me have done nothing to help my condition. Almost two years later, I am still experiencing discomfort, although the pain is not as extreem. I’ve even done another IM since (ran 3:29 at IMFL). My question is; does anyone out there have any suggestions? Mail order orthodics, stretches, drugs, anything???
I’ve perscribed orthotics for these and always specified an extra metatarsel pad be built into them. The best person to person to see is most likely a podiatrist that has running injury experience. To give you an overview of this condition
I also suffer pretty badly from it. I have gotten real relief by adding, what effectively, is a fairly thin doughnut pad to the underside of my orthodics under the neuroma. The pad goes from one side of the ball of my foot to the other, and the hole is just large enough to provide a trampoline where there is pain. I use insoles from running shoes for the pad and just cut off some of the toe area and the area behind the ball of the foot. It works like a champ. As long as I run and bike with it, I am fine. As soon as I do anything without it, I end up in pain.
litherland
If what I have just described is a metatarsel pad, I’m sorry for stating the obvious!
What’s worked well for me is a trick Johnny Halberstadt at the Boulder Running Co. showed me: cut a small circle of orthopaedic felt and stick it to the bottom of the inner of the shoe, just behind the metatarsals. It usually takes a few tries with each new pair of shoes to get the pad situated just right, but once it’s there, it lifts and separates the metatarsals and relieves the pressure on the neuroma. This helps with the pain and helps prevent further damage.
Placement of the pads is critical - this is why any consumer product except a custom orthotic probably won’t work. Doing it yourself allows for cheap trial-and-error until the pads are exactly right.
I tried some expensive custom orthotics, but they didn’t work as well as the pads, so junked them. I looked into surgery, but the anecdotal evidence I have so far is that of 9 surgeries, 5 of them re-grew the neuroma in less than 2 years. That doesn’t sound like worthwhile odds to me. Several doctors whose opinion I respect do recommend the surgery as an option, however.
it’s critical to have plenty of room in the toe box of ALL your shoes, running, bike, and work/casual. Compression of the metatarsals is a factor in this injury. Make sure to get running shoes with excellent forefoot cushion, that’s the primary characteristic I look for these days; and replace them often. Try running on softer surfaces - grass, dirt roads, or synthetic tracks. Concrete is a terrible surface to run on…
Also, be careful of running with the pain. Last year, I didn’t put the pads in a new pair of racing shoes, and consequently tore a calf muscle because I was compensating for the neuroma pain by altering my pushoff. Stupid stupid stupid.
My orthotics are actually cut out around the area that was in pain, allowing that metatarsel to push down a little lower before encountering something firm. It works.