*This is a guest post by my friend Ben Drew*
The feet are kind of the most important part of the body when it comes to running. That’s why pain in the foot is the last thing any runner wants to be dealing with.
The frustrating thing about foot pain is that it can be caused by a very wide variety of things. Narrowing down on the exact area of pain can help you to find out exactly what’s behind it.
If you’re plagued by pain in the ball of your foot between the 3rd and 4th toes, you may be running with Morton’s neuroma. This inflammatory foot condition is usually an overuse injury, and it requires some lifestyle and gear changes as well as the usual treatment.
Let’s explore the condition and how to deal with it so it doesn’t ruin your running.
What Is Morton’s Neuroma?
Morton’s neuroma is an inflammatory foot condition that leaves you with pain in the ball of your foot. It’s basically an overuse injury, as it often develops due to constant and consistent pressure or force on the forefoot.
It’s worth noting that this condition is not a true neuroma. Neuromas are tumors of the nerves, but Morton’s neuroma is simply a thickening of the tissue in the nerve.
The soft tissue around the nerves in the forefoot begins to thicken after a long period of consistent pressure or hard force. As they thicken, the metatarsal bones begin to rub against them, causing pain and more inflammation.
It can also begin to put pressure on ligaments surrounding the nerve, which is why it manifests as pain, numbness, or a tingling sensation in a very specific part of the forefoot.
Strangely, it tends to occur in only one foot.
How Does Someone Get It?
There are two things that put you at high risk of Morton’s neuroma. Number one is exercising or taking part in high-impact sports – for runners, both boxes are checked here.
Our feet take up to 4 times our body weight in force when we run! Imagine how that’s increased when you jump or play sports like basketball or racquetball.
The second thing that can lead to Morton’s neuroma is constant pressure on the toes from an ill-fitting shoe or a shoe with a tiny toe box. Women are at significantly higher risk of the condition developing if they wear high heels!
These two things place a lot more pressure on your forefoot than there should be. This is basically constant trauma to your bones and nerves, which results in plenty of inflammation.
Those who have existing foot conditions, such as bunions, flat or high arches, and hammertoes, may also be at higher risk of getting Morton’s neuroma.
In short, anything that causes you to change the way you walk can lead to this condition. Because you’ll be distributing pressure differently across the foot to what it’s used to, there’s a high chance of those nerves becoming strained and inflamed.
Additional Resource – Should I run in miles or minutes?
What Are the Symptoms of Morton’s Neuroma?
The symptoms of Morton’s neuroma usually only show up a little while after the nerves become inflamed. Usually, the first time you’ll notice any sign that something isn’t right is after being on your feet for a long period of time.
The first symptom is usually an uncomfortable and definitely noticeable pain in the forefoot. This may be accompanied by a tingling or numb sensation in the ball of your foot.
You may also experience an uncomfortable feeling like there’s a pebble in your shoe right under the forefoot, which is a result of the inflammation of the nerve between the metatarsal bones.
The worse the inflammation gets, the more intense the symptoms will become. In mild to moderate cases, it begins after spending a lot of time on your feet.
When you run, the pain may start 10 to 20 minutes into your run, cutting it short. Every step can feel like an electrical shock going through your foot.
In severe cases, the pain may last for days or weeks at a time, effectively ruining any sort of training program you may have been following.
Additional resource – Running with osteoarthritis
Is Morton’s Neuroma Common With Runners?
Morton’s neuroma isn’t specific to runners, but they may be at a higher risk of developing it. Because your feet take a lot of pressure when they’re pounding the pavement, that finicky nerve in the forefoot can take some strain.
Non-runners are also fairly prone to developing it if they play other high-impact sports or wear the wrong shoes.
But runners who also fall into other high-risk categories are the most susceptible to this painful foot condition.
If you run, you’re already at risk. But it’s more common in runners if they:
- Wear running shoes that don’t fit properly
- Wear running shoes with a small or tight toe box
- Do high-impact cross-training
- Spend time in high heels when they’re not running
- Have existing foot conditions
Can You Continue Running With Morton’s Neuroma?
Well, you can keep running with Morton’s neuroma. But should you? Probably not.
When you run with Morton’s neuroma, you may feel sharp, electric pains in the area under your toes. Every time you step on the foot, you’ll most likely feel a stabbing sensation, possibly with tingling or burning. Nobody wants to run with that!
The pain in the ball of your foot is relieved by rest. It’s a good idea to stay off your feet while suffering from Morton’s neuroma, until it’s healed. You may have to reduce the volume of your training until it’s eased up and you’re no longer experiencing symptoms.
Keep in mind that rest should be used in conjunction with other treatments.
What Treatments Are There for Morton’s Neuroma?
Treating Morton’s neuroma effectively relies on fixing the things that are causing the condition in the first place.
If you’ve done all you can and you’re still struggling with debilitating pain, your doctor may be able to give you corticosteroid injections to reduce the inflammation, in turn lowering the pain.
Alternative therapies like acupuncture may show some results in improving pain. As a last resort, Morton’s neuroma surgery may be recommended.
But before we get that far, here are the steps you should be taking to reduce inflammation and relieve pain in the ball of your foot. Implementing these can make a huge difference to your pain!
Ice and Anti-Inflammatory Drugs
Ice can work wonders for forefoot pain.
Try to ice the painful area 3 to 4 times every day, for about 20 minutes at a time. Don’t place an ice pack directly on the skin, though. Wrap it in a cloth before placing it on the sore area.
If icing doesn’t alleviate the pain to a point where you can continue with your daily life as normal, you can take non-steroidal anti-inflammatory medications to ease the ache. They’re easy to get over the counter, just make sure to follow the instructions closely.
Change Your Shoes
Making the change to more supportive shoes can be a huge help.
The first thing you should be looking for in a pair of shoes is a spacious toe box. The easier it is for the toes to splay, the less chance there is of the nerve being pressured.
As well as toe space, there should be enough support for your arch. If you roll your feet inwards when you walk, you’ll need a stability shoe, but those with a neutral foot can wear a neutral shoe.
Making sure your foot is properly supported means that your body weight is evenly distributed. There’s less extra and unnecessary pressure on particular parts of the foot, so the nerves can be free of stress.
Choosing a shoe with a low heel-to-toe drop can also have a positive effect. The standard heel drops come in at 10 to 12mm, but investing in a show with a 4 or 5mm drop can drastically reduce pressure on the metatarsal bones.
It’s advisable to get new running shoes, work shoes, and everyday casual shoes for Morton’s neuroma. But that’s not always a practical or affordable thing to do, so we recommend buying one pair of new shoes and using met pads or insoles for the others.
Met Pads or Insole
Insoles can provide support for your feet that you aren’t getting from your shoes. It’s important to note that some shoes may not accommodate insoles. But generally, any shoe that has a removable insert in it can fit a custom insole.
They also add a touch more cushion underfoot, protecting your foot and absorbing shock. But the real benefit is that they realign the foot to reduce pressure on the sore spot.
If you don’t want a full insole, you can try a metatarsal pad first. These fit right behind the metatarsals, in the dip behind the fatty pad on the ball of your foot.
They do a similar thing to the insoles – provide support and reduce pressure on the neuroma by aligning the foot correctly.
Cut Back on Mileage
One of the easiest ways to fall right back into stabbing pain is to keep doing the same activities at the same level of intensity.
To lower the pain and speed up healing time, you should be resting your foot. This may mean taking a week or so off from running. Along with rest, you can stretch and massage the foot regularly throughout the day.
If you really can’t do without your weekly exercise, at the very least cut back on your mileage. You don’t want to be halfway through a run when you’re hit by crippling pain, so halve your mileage until the condition eases up.
When Should You See a Doctor?
There’s no need to see a doctor immediately when you notice the symptoms of Morton’s neuroma. Implementing the above home treatments can make a huge difference to your pain, and can actually allow the space for the condition to heal on its own.
But if you don’t feel any improvement after giving these treatments a try, it may be worth seeing your doctor to explore other options.
Don’t hesitate to visit your medical practitioner if you need to. Surgery is usually the last resort, and your doctor will be able to advise you on the best course of treatment for your particular case.