Morton’s neuroma

Has anyone had any issues with Morton’s neuroma and had success treating it?

I gave up running because of it and switched to cycling and for a couple of years it’s been ok… but it’s flared up again recently and riding is VERY painful.

Any advice would be great,

Thanks all :grin:

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I don’t know if this advice applies to an actual medical condition rather than just “the balls of my feet hurt a bit”, but… have you tried custom moulded insoles?

They provide better support and mean that the pressure of the pedal stroke is spread more evenly over the whole foot.

Been dealing with mine since 2004. I’m able to keep it at bay by 1) wearing wide shoes, and 2) wearing a metatarsal pad in ALL of my shoes, including my cycling shoes.

This works for me, but that damn neuroma is there waiting to remind me any time I don’t do both things listed above. On a bike ride last winter, I wore super-thick socks and replaced my normal insoles (with metatarsal pads) with other insoles. That neuroma starting hurting again almost instantly.

The doctor who originally diagnosed the neuroma in 2004 said it would probably get worse over time until I would have to do something more drastic, but thankfully I have avoided anything like surgery or that saline injection thing they can do to kill the nerve.

It quite often has a link to calf tightness as well. Dig in to the calves and find adhesions that many times accentuate the issue as the entire thing is a chain. As mentioned previously, shoes that are tight and compress the metatarsals are an issue as they cause the nerves to inflame and swell, and then the ugly cycle is started. I switched to a wider forefoot shoe, with a slight bit more ramp (running) and cycling shoes that allowed the metatarsals to spread a bit more when pressure is applied. That really has helped and I’m not slowed at all with it. It’s funny how many foot/lower leg issues are somehow often related to calf muscle issues. Good luck…

Surgery was the only thing that worked for me. I’m going to say that was about 8 years ago and haven’t had a problem since.

Surgery for me as well, no problems since. Before surgery, tried to manage it with wide shoes, inserts, tried cryo, injections, etc. All those things helped a little, but it still sucked pretty bad until the surgery. The surgery can actually make things worse for some, so it’s a bit of a gamble I believe.

I wear custom orthotics in my walking shoes. I walk between 15 and 29 km a day for work. Sometimes it heats up and I need to take the shoe off and let it cool down or rest.

For cycling Ive been lucky. I bought shimano shoes in road and mtb. Both level 3 shoes in a 45 wide. Ive been able to ride and almost never have issues. In my most recent bike fit the retul guy pushed some specialized insoles on me and they have actually made it so that I have not had an incident with the mountain shoes they are in. I’m very happy about it. I might get a another set for my road shoes but I almost never wear them. Actually thinking about it I have only had one issue since my most recent bike fit where he changed the location of the cleats on my shoes. He alos lowered my saddle by 3 centimeters on one bike and 1.5 on the other. This has changed the angle of my foot and made it much more level and not pointed down like it was before.

Good luck.

Thanks for all of the advice.

After the flare up I made some DIY cleat wedges (https://blog.bikefit.com/mortons-neuroma-in-cycling/) albeit under my insole rather than amending the cleat itself. They worked an absolute charm so I’m going to look into some customer insoles and hopefully that keeps it at bay!

Thanks again :grin:

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Custom insoles with metatarsal pads are obviously best, but you can get insoles with metatarsal pads or even just add the pads. I have done that with some success.

I just got the diagnosis today actually. The cortisone shot has increased the pain tenfold but I’m hoping it’s just for a night.

Thanks to the above I’m going to order some wedges to see if that works for me. A trip to a fitter would be next but other than this I’m pain free for years on the setup and the other foot is fine.

After that, surgery I suppose.

What was your recovery time after surgery?

Recovery for me was something like 5-6 weeks before I was back on the bike. There was a lot of bruising initially and tenderness. I remember my dog stepped on my foot during the second week. That hurt a bit. I was also in one of those sandal boot things for at least 3 weeks I want to say.

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Yikes thank you for sharing. I’m going off the deep end in terms of finding alternatives to surgery. So far cutting a hole in the sole of an after market insert with the metatarsal pad has worked wonders. Fingers crossed this is going to heal without the knife.

I had great success using KT Tape for Morton’s Neuroma several times…actually the only thign I have ever found KT Tape to work for (I generally think it is snake oil, but that is a different thread).

take a length of tape long enough to go from the middle, top of your foot forward around the front of your foot (but not around the toes, you’ll cut holes for them) and wraps to the same middle point on the bottom of your foot. Cut two diamond shaped holes in the middle of the tape to accommodate the two toes which are on either side of the neuroma.

Put the tape in place with the two toes sticking through. Then use a length of tape perpendicular to that piece and wrap around your foot to help hold the first piece of tape in place.

KT Tape helps here not because of any “magic” in the tape, but because it acts as a separator between your two toes causing the impingement resulting in the neuroma.

I’ll see if I can find the video for this, but last time I looked I couldn’t find it again.

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Oooh…I found it!

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I don’t blame you one bit!

I tried different shoe inserts and the doctor did a couple of cortisone shots as well before we moved to surgery. Those options provided some temporary relief but it came back each time. The surgery was pretty simple (from my perspective since I was out the whole time :slight_smile: ) and, once past the recovery period, I was able to ride again pain free.

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Interesting idea and it does seem like it would work.

Anecdotally, it has worked multiple times for me. Almost immediate relief.

Hopefully this thread will be a good resource for people looking for relief for this. I had this issue from March and I tried to tough it out. That made it a lot worse, hard to walk, impossible to ride without considerable pain. My cadence went through the roof (88 average up to 105-110) as I was spinning to compensate from putting down any real power. Went to the podiatrist, helpful with the injection but not helpful in terms of non-invasive methods for dealing with the injury. Even though they were a sports medicine specific podiatrist, they didn’t offer custom insoles and didn’t even offer that as a viable solution.

I ordered 4 brands of insoles off of Amazon. For me the “Sole” brand felt the most racy, more like a carbon fiber shoe sole, very stiff, I would recommend. But, the actual insole was thin in the toes. So with the metatarsal bump and the support, I liked it and will use it. So far though the Powerstep brand has been the ultimate winner. It’s a little thicker but that thickness allowed me to cut a hole in the sole around the effected area to relieve pressure. Bingo - two pain free rides after 4 months of misery.

My best tricks thus far:

Steroid shot
Sidi Mega Shoes (never worn a wide shoe in all the years and miles until now)
PowerStep Insole with a cutout
BikeFit in The Shoe Wedge, one in each shoe
Adjust saddle height up to compensate for the extra height in shoe (I laughed at people that used to suggest this. I’m eating crow now, it matters)

I will suggest good pair of shoes, Strapping and Steroid injection. If all fails then surgery is the only success.
See a good physio, Biomechanical assessment and good shoe fit. Read more on steroids

What symptoms do people start your with? I’ve been getting a pain in the middle of the ‘pad’ of my right foot. I only get it after riding long miles and today it kicked in around 55 miles. I’ve had it on the trainer as well but it usually disappears.

I’ve been thinking it may develop into a real issue - what have been people’s progressions?