A look at Morton’s Neuroma / Hotfoot.

A look at Morton’s Neuroma/Hotfoot.

A number of runners and cyclists experience pain over the metatarsal section of the foot while training. The pain very often comes from a condition known as Mortons Neuroma or described as hotfoot by cyclists. 

The Neuroma is found between toes 3 & 4, with your big toe being number 1 and your baby toe being number 5. Toes 1,2 & 5 have their own nerve supply. Toes 3 & 4 share a nerve. This nerve can get squashed between the toes and the resulting inflammation results in the pain that is experienced.

Symptoms include pain in the ball of the foot that shoots into the affected toes, burning and tingling of the toes. Some people feel as if they are walking on a stone or marble.

What can be done?

For Cyclists –

  1. Move your cleats back toward the heel of the shoe. In so doing you place less pressure on the nerve.
  2. Experiment with a wider pedal. This will help dissipate pressure around  more of the foot.
  3. Make sure that your shoe has a metatarsal button in it. There are products that can be fitted-  Pearl Izumi makes an inner that can help. It is also possible to make a metatarsal button.

For Runners –

  1. Come and do a leg assessment. We will film your running gait. An exaggerated heel strike will result in your foot slapping down hard on the road and thus exaggerating the condition.
  2. Make sure that your shoe is not tight. You want space between the toes.
  3. Get a metatarsal button inserted in your shoe. I can help with that.
  4. Make sure that you are in the best possible running shoe. Pronation, foot shape, arch integrity all need to be taken into account.
  5. You can also miss the second set of eyelets when you lace your shoe. This will give your forefoot more space.
    mortons lacing

In General –

  1. Avoid tight fitting shoes. Any shoe that places pressure on your baby toe will carry that pressure through to toes 4 & 3.
  2. Make sure that you are on a diet rich in natural anti-inflammatories. Up your intake of fish oil, olive oil and green vegetables. Avoid too much white flour and sugar, which have the opposite effect.
  3. You can take a non-steroidal anti-inflammatory such as Cataflam or Voltaren if not contra indicated for you.
  4. Avoid wearing high heel shoes.
  5. Make sure that your calves are well stretched and if necessary go for a soft tissue massage to as to lengthen them and thus place less pressure on your fore foot.
  6. Roll a tennis ball under your foot regularly thus giving your foot a massage.
  7. Wiggle your toes regularly so as to free  movement in the foot.

If all else fails –

  1. Get an insert made for your shoes by a podiatrist.
  2. Your doctor can give you a cortisone injection into the site so as to reduce the inflammation.
  3. Surgery in which the nerve is resected is sometimes suggested. However such surgery is not always successful and can leave the patient in more pain than before the surgery.

Hope that helps.


Mike Roscoe.

Mike Roscoe

About sbrsport

SBR Sport specialises in Swimming, Biking and Running. On the medical side we are able to do intensive bike setups, leg assessments and soft tissue release.
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2 Responses to A look at Morton’s Neuroma / Hotfoot.

  1. serjio says:

    This is good info! Where else can i find out more Keep up the good work

  2. Bo says:

    Nice article. I struggled with it for most of 2012. Landed up going for Lyno therapy to help with my running. Eventually, what helped was my shoes. I wear a size 5, but landed up with size 7.5 running shoes. The pain has gone away. I feel it a bit post run and sometimes when I rub my foot. But it’s 100 times better. Great blog!

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