Morton’s neuroma is very simply an inflamed nerve. As the space and the mobility of the space inbetween the 4th and 5th and 1st and 2nd metatarsals are both quite enlarged, it mostly appears in between “2nd and 3rd” or “3rd and 4th” metatarsals, what is a bit more enclosed, so a little inflammation will already increase the pressure. We can have a very similar pain, coming also from a nerve, under the big toe, but from to other causations, called a Turf-Toe. Honestly the treatment can be the same or similar.
The nerve itself can be actually inflamed, the nerve tunnel or any of the tissues can be damaged and swollen or basically it can be anything around the nerve that can be putting extra pressure onto that area of compressed space. The thing is, that as humans we walk a lot and we spend normally our lives on our feet, putting this inflammation out is a pain in the back. Sorry, pain in the toe. A lot of people turn to surgery after years and years if not decades in some cases of debilitating pain.
The causes ? Direct, sudden, accidental hit to the area or to the surrounding zone. It also can be years of pounding with a bad foot strike. It can be decades of bad shoes. It can appear, if we were overweight and put too much pressure onto our sole, simply by walking. It can be caused and accelerated by other foot conditions, like a turned, squeezed and calcified pinky toe and big toe. Many other stuff can flare this up. Shoes, slippers, maybe even nutrition and hydration in conjunction with other aspects. Who knows. I know only, that once it’ there, it will damn want to stay there very stubbornly.
I had it twice in the last 20 years. Last year it happened again the 3rd time. In February, I felt very very sick first time ever in my life. It was covid, flu, grip, infection, who knows. I was on the floor for a week, then for 2 more weeks, I was not able to work due to giant blood pressure fluctuations. Standing up was triggering a black curtain and being on the sun for more than 5 minutes caused me to have fever.
4th week I started get back into training. Nothing fast, just sensible mileage, low heart rate, no intervals, nothing. In one month, thanks to a lot of very low intensity pilates, mobility, yoga and super-slow bodyweight stuff, I gained back some of the lost weight and completed a race I initially signed up. I actually did 12th place in a quite stacked field.
I chose a shoe, that I used to love back in the day, the Saucony Peregrine, edition 12. I actually felt squeezed and well held in the shoe, so I used a thin pairs of socks, that worked very well in training. I KOM-med already a couple of up and down technical strava segments and felt comfortable wearing it for 21km. It was rocky, a lot, but also it was a very hot day for end of april. My feet were sweating and I was sliding all over the inside the shoe. I was not able to hold quality foot tension, but was trying keep my stride correct and focus on the terrain. I hit a couple of rocks, had my toes squeezed on the front, hit a couple of more rocks and so on. I don’t mean hit, like accident hit, but stepped on them rocks with a soft foot.
Probably had some pre race stuff going on too with that foot, I cannot remember. I am a trail runner, I have been running over rocks for nearly two decades, no one race will put me in a wheelchair.
Anyways, long story short, I was not able to walk properly for 3 days. I had a lot of pain, shooting up by my sciatic, up to my neck when stepped on that nerve. I had to stop training multiple times during the next 4,5 months. I had 3 or 4 occasions, that it flared up so bad, I could not walk and did not get to work either. I constantly walked on a bump as it was swollen all the time, giving me serious pain. It often woke me up during sleeping too.
Consistency is key
The journey to healing will never be easy and will be painful, until it is not. I mean this. This is a freckin’ nerve. There is no slight pain and slowly ameliorating condition and healing. It is sharp pain and not healed or no pain and healed.
The poking around the tissue for me was constant. I got a non-sharp metal spoon, applied a little coconut oil to the sole of my feet and was digging everywhere, turning, twisting, pulling, pushing squeezing. My entire sole and plantar fascia. Like a home made Graston tool.
I used a lacrosse ball to constantly roll out my fascia. I also applied at least 2 times a day high compression, using a bike inner tube, then did my toe, feet and ankle mobility drills. You can call this voodoo flossing if wanted. I did actually the toe exercises at least 5 times a day. 1 to 2 minutes.
I also was foam rolling hard 2 times a day, just in case I find a tight spot somewhere, that could have been correlated to my feet. I did roll out my calves deeply with THE STICK too.
You can check on youtube some nerve flossing exercises. I did those too and still do some of them, that I found beneficial. I am not gonna state stuff that I am not sure of, but this is the time I started including Foundation Training into my daily routine. This reinforced my spinal area and improved my back function. Still does.
I also simply self massaged, using a lot of different kind of essential oils. Cinnamon, peppermint, lavender, tea tree, rosemary, ravintsara. Not together of course. AM stimulating, PM calming.
Applying a quality silicon (silicium) based cream 4 to 6 times a day was crucial in the treatment. I used a french brand GSA. I did 1 month of drinkable mineral silicium cure, than continued for 2 months with plant based silicium (stinging nettle extract) .
Hot and Cold
Icing with a pack do not work. It is too localised. You gotta calm and un-inflame the entire area. I soaked my whole feet ankle down to ice cold water for 15 minutes every evening. I don’t believe that for curing, cold on it’s own is good. The mixture of cold and hot is way more stimulating. After 15 minutes of icing I turned on my infrared lamp also for 15 minutes and repeated the procedure. Yes it takes 60 minutes, so I made sure I had a good book on the side every evening.
If you were sure that you could be walking after icing, to train the ability of your body/foot, to bring blood back and heat up the area, then agreed, icing is good. Those were some painful sessions for me. I walked in the sea, what was very very cold, for 20 minutes while my daughter was playing in the sand. Then put on some hot socks and walked for an hour, till I totally heated up my feet. I am telling, you that deep annoying itchy pain, that you get, when blood is rushing back, is just not comfortable.
There are stuff, that I found extremely beneficial, as you can use them near permanently for long periods, so they make the most changes. Yes, the physio-therapy, massage, electro-stimulation, icing and all creams, lotions and potions are great, but when you can apply something for hours on end, that is even better. Well, I would not say better, as it is not comparable, but it is the best possible addition to a treatment.
I used a poultice made from Zeolite or Green Clay. I mixed in same cinnamon and curcuma, couple of drops of essential acids, maybe ginger and some charcoal. That is so cheap, so simple and you can were it all night while sleeping and even during the day if you were at home. That is 8 hours of treatment. I applied bottom and top of my foot too. Wrapped in plastic bag and pulled on a hot pair of socks.
The second stuff that you can do in the meantime, for both feet actually, is to use a toe spacer. I bought a cheap pair of gel toe spacers for like 3€50 on aliexpress and I am still using and very happy about it.
I don’t think that I have to mention, how crucial it is to wear proper shoes. Wide toe box, nearly flat and flexible shoes. In my case, I really enjoyed walking short distances in very minimal shoes like VFFs and Vapor Gloves, however for running and hiking I prefer something more substantial. I used to have a lot of Altra shoes and other similarly shaped ones like Topo. I changed them up for a couple of Nike and Terrex shoes, got some cushioning going on, started running in the Zinal and Tecton from Hoka too. My shoe rotation had exploded. I always had many shoes, but they were all zero drop, wide toe box shoes. Now I have everything from 0mm up to 10mm drop and all kind of toe-boxes.
These are just running shoes though. Your lifestyle shoes should be properly sized, with enough width.
Most importantly I started including a little support into my daily shoes. I saw a couple of physio videos, where, to alleviate pressure, the therapist included a little foam patch on the sole, just behind the painful area. In this way, when you walk, you actually roll over the morton’s and won’t put direct immediate pressure on it. I had a couple of sudden successes in races, where I had zero pain. However, it is complicated to apply that on your feet all the time and not so time efficient.
I dialled in the spot, where I needed the bump and sticked the support on to all of my shoe-insoles. Instead of expensive physio gel pads, I used 50cent chair sliders. You know, these noise dampeners, to protect your floor and your ears. Literally 50c. I glued those under all my insoles. In some cases I applied a bigger one and a smaller one on top. That worked like a charm in all cases. Especially during work.
With these quality daily habits, I took around 4.5 months to heal and to be pain and symptom free. As a running coach and personal trainer, of course, I had already been doing many exercises for my feet and spine, but I learnt a lot during this period of pain and healing. Especially the Foundation Training, what is sort of life changing for someone tall or who have issues with sciatica, back pain, bulging disks and so.
I always believed and believe, that the human body can heal and can become better. It needs, rest, stimulation, time, nutrients, space and patience, but permanence too. Whatever we did for a decade or 2, won’t go away in days. Sometimes, we got to pay the price in pain, discouragement and other not so comfortable feelings. However, sticking out the hard times and learning is always rewarding ! When you find a solution to a problem, you make the universe a better place. Even if it was your own issue !
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