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Injury Prevention

Are Your Running Shoes Too Tight?

If you’ve experienced burning pain in the forefoot that radiates into the toes, you may have what’s called Morton’s neuroma.

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If you’ve experienced burning pain in the forefoot that radiates into the toes, you may have what’s called Morton’s neuroma. It’s typically initially worse during running, but eventually may occur when walking or at rest.

Morton’s neuroma is a fibrous enlargement of the plantar nerve where it passes beneath the transverse metatarsal ligament. While the name may sound scary, it’s just fancy doctor-speak saying that an important nerve in your forefoot is rubbing against a ligament and doesn’t like it one bit.

Compression—usually from tight shoes—is the main cause of the problem because it comes from the nerve repeatedly being pressed against that ligament, which leads to inflammation. Running can worsen the condition once it starts.

Women are more susceptible to this problem because in addition to athletic shoes, high heels and other shoes that constrict the toes can exacerbate or accelerate a mild problem.

You can first try to ease or eliminate the symptoms with the home-based suggestions at right, but understand that this will not fix the condition. It will only bring relief and delay further progression.

Morton’s neuroma is not dangerous, but it can be extremely uncomfortable. Treatment can be delayed as long as the symptoms aren’t too severe. However, some form of treatment will eventually be required to return to normal athletic performance.

Fix It

Try an NSAID. An anti-inflammatory like ibuprofen or naproxen can help alleviate inflammation in the foot.
Give ’em space.
Switching both athletic and everyday shoes to pairs with larger toe boxes can help relieve pressure on the affected area.

Prevent It

Wear proper shoes. A well-fitting shoe that doesn’t compress the forefoot and toes can help. Women, wear high heels and toe-compressing shoes only when necessary.

If the home-based remedies above don’t help, see your doctor. If Morton’s neuroma is diagnosed, the initial treatment is to identify the neuroma with an ultrasound and then inject cortisone directly into it to shrink it. If effective, this treatment relieves the pain and patients don’t need surgery, which is always the last resort because it comes with risks of subsequent forefoot instability.

New York City sports medicine specialist Jordan D. Metzl, M.D. is a 33-time marathon finisher and 14-time Ironman. His book, The Athlete’s Book of Home Remedies, has more than 1,000 tips to fix all types of injuries and medical conditions.