Your poor feet absorb more force than any other part of your body - and running obviously compounds that considerably. So when something goes wrong, it can be very painful, very annoying and very hard to avoid!
How to tackle tight hamstrings stress fracture – to get more articles like this delivered straight to your inbox, plantar fasciitis. But it might in fact be a common condition known as Morton's neuroma.
Fortunately, if it is, there are some simple home techniques you can try to ease the symptoms and get back to running ASAP, though of course, always see a physio or medical professional for a proper diagnosis.
What is Morton's neuroma?
Morton's neuroma is defined as the enlargement of tissue around a nerve in the ball of your foot, usually between the second and third toes (although sometimes it occurs between the third and fourth).
What causes Morton's neuroma ?
It occurs when the nerve is irritated or damaged and becomes inflamed due to 'mechanical stress'. This could be triggered by any one, or a combination of:
- or perhaps even blaming that common curse of runners
- Back pain from running? This could be why
- Poor running technique
- Overtraining
- Tight calves
- Flat feet
- Bunions
- Claw foot
- High arches
Who is likely to get Morton's neuroma?
Morton's neuroma is most common among people between 40 and 50, but it can occur at any age, often developing unexpectedly and worsening over time. If you neglect to take action, this agonising and frustrating condition can lead to permanent nerve damage, leaving you parked on the sofa long-term.
However, when Morton's neuroma is caught early, the inflamed tissue around the nerve settles down and the symptoms resolve themselves. Left unchecked, however, the irritated nerve thickens and becomes progressively more painful due to the increasing pressure.
What are the symptoms of Morton's neuroma?
The most prominent symptom of Morton's neuroma is intermittent pain that starts when you put pressure or weight on the foot – either when you lace up your trainers, or once you've set off – and only eases when you take off your shoes and massage the area.
It can feel like a sharp or dull twinge emanating from the ball of your foot, though some runners only experience the pain in their toes. People often liken the sensation to standing on a pebble or marble, a scrunched-up sock, or even razor blades.
The area may throb or sting as the pain radiates out, or it might feel numb with pins-and-needles. The symptoms of Morton's neuroma can be intense, and some people have a hard time walking because the pain is so severe. There's no noticeable swelling, though.
The first symptom of Morton's neuroma is often numbness, so if you lose the feeling in your toes every now and again, it's a sign to take action with home remedies. If you're further down the line – in excruciating pain and hobbling – there's a chance you might need a surgical procedure, called a neurectomy, to remove a portion of the nerve.
How to tell if it's Morton's neuroma
If you start to experience foot pain, you should see a doctor or podiatrist straight away for an accurate assessment. They'll usually be able to suss out Morton's neuroma by manipulating the foot, but may refer you for an X-ray, ultrasound or MRI scan to rule out other causes if necessary.
There's also a test called Morton's test, which, again, is best performed by a qualified physio. It is done by holding the forefoot with one hand (by clasping all five metatarsal heads with one hand) and then applying pressure to the top and bottom of the intermetatarsal space with the thumb and index finger of the other hand. Pain is indicative of Morton's neuroma. There's a link to a video of the test here.
How to treat Morton's neuroma
Once you've been diagnosed, you might be advised to change your shoes, take painkillers and try stretching exercises. If the pain persists, you may be referred for steroid injections to calm the nerve down, 'with the worst case scenario involving surgery,' says podiatrist Dina Gohil, founder of DG Podiatrist and ambassador for CCS Foot Care.
The longer symptoms persist, the harder it can be to fix the problem, so utilise every tool in your arsenal to treat minor pain at home. 'Ice the area, try and keep the foot elevated as much as possible, and wear insoles or pads to help splay the forefoot,' Gohil says. 'Take painkillers as needed. You may use anti-inflammatory gels on the area also.'
Give your foot the chance to mend, too. That means taking a tactical break from regular running in favour of low-impact activities, like swimming. 'As Morton's neuroma is usually associated with repetitive sports movements, depending on the severity, it would be advised to rest and let the foot heal first before continuing exercise,' Gohil adds.
Theres also a test called running shoes. 'You want a shoe with a wide width to prevent the toes and forefoot from being squeezed,' she says. It's also worth fitting your shoes with metatarsal pads, which sit underneath the middle of the foot, taking pressure off the nerve to give it a chance to recover.
Does Morton's neuroma go away?
Around one third of people with Morton's neuroma get better after switching up their footwear and using metatarsal pads. Test running shoes before you buy them by removing the liner or insole and standing on it – if your foot is wider than the liner, it'll squeeze your metatarsal bones together and irritate the nerve.
If you suffer from Morton's neuroma, you might find that your symptoms come and go over a number of years. When the condition flares up, it's likely to causes of hip pain and how to fix the problem for a little while. But with proper care and adequate rest, you'll be back at the start line in no time.
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