I appreciate the video. For a couple years after my neuroma’s developed, I did wear shoes that were both for stability and had a wide toe-box. However, several months ago, I strayed from the stability element and feel like my feet are becoming even healthier. Even getting some of my arches back. My last purchase (US) was a Hoka running shoe with a carbon plate. I had to incorporate them in quite gradually, especially when the shoes were newest.
Hi there. For trainers I recommend Run and Become in Victoria London, For Xsensible shoes and good walking shoes I can recommend. Precious Soles in Potters bar, London. Sketchers are widely available. Functional 3 swimming shoe is available on Amazon. Most of the shoes are easily found with a Google search.
It is curious that you mentioned flat feet repeatedly, but did no mention those with high arches being susceptible to Morton's Neuroma. Which shoes would you recommend for we with high arches and MN? I have heard Hoka being recommended. Thoughts on Hoka shoes?
Yes, agreed and I will cover this in a new video. Abnormal pronation and flat feet often poses a more significant risk although a high arched foot with little motion does lack shock absorption and this can also be a cause. For supinated high arched feet I would suggest the Asics Nimbus. The main thing is to avoid a pronation controlling shoes. The Xsensible is also a good option from Precious Soles / Potters Bar. Hoka shoes would be fine but stick with a neutral rather than a stability model. Often, high arched feet have quite a square toe shape in which case the Altra Paradigm could be considered because it has reasonable shock absorption but only if calf flexibility is reasonable.
The Greek foot poses a significant risk to Morton's neuroma. Especially between the 2-3 toes. Check out our video on this subject (Foot shapes reviewed) . The Kuru looks well made but we haven't tested it in our laboratory so cannot say more than this at the moment.
II can only find some of these shoes online. There is not a shoe store where you can try them on anywhere in the Northeast that have these shoes in stock. You can have them delivered to some stores if you buy them first. Who wants to do that? I found some stores near me that carried a couple of the brands mentioned in this video but none of them had wide sizes or even thought they would be able to get them. There was a couple of shoes that carries Hoka shoes which are good but again none of them carry wide sizes. It is an order online world.
Yes this is very frustrating but a sign of the times with so much more mail order shopping. Many of my patients accept the inconvenience of online ordering knowing they can send them back if there is an issue. It is frustrating though !
What of these shoes are available in Italy ? Many of the models you have mentioned on this video i have never heard to talk about . Thank you so much. Patrick from Italy
I quite like them for the right patient. They are wide in the toes but obviously very minimalistic which can be an issue if you have a lack of padding under your feet or if you walk on hard surfaces. I will soon be uploading a video on off the shelf insoles that can be used with shoes like this so as to offer a bit more protection for those that need it. These shoes offer minimal support which is fine for some but not if you have a flat unstable foot or tight calves !
Though I have growing pain in my left foot…..I only recently received a podiatrist’s diagnosis here in USA. I am receiving laser and massage on that foot….and making footwear changes. I no longer can wear my ‘bargain price’ sketchers. 🥲…..but am wearing flip flops, and much wider shoes, icing….turmeric tablets, etc. I have high arches too. Ugh. So I will continue to experiment with all this until I am at ease. Ahna
Good luck ! sounds like you are taking the correct approach ! Fitflops (sandals) are often better than flipflops because of the rocker and increased cushioning
Your video is very helpful indeed. I suffer from Mortons neuroma and although I wear orthotic insoles , it depends on the shoes structure let's say. Even if I wear athletic shoes the pain still exists in some cases. I recently found in stores , Asics gel nimbus model which has the characteristics you described and when I tried them at the store I realized from the 1st moment a great difference in walking. I am going to buy them . Your video came at the right time , where I.was looking for the proper shoes for me to wear. Many many thanks
Many thanks for your question. In some cases, two months post-operation might raise concerns about abnormal reactions around the nerve if recovery isn't progressing as expected. This could be due to scar tissue binding to the nerve where it was cut, or a true stump neuroma forming. However, it can sometimes take longer, with three to four months before symptoms of a stump neuroma become more obvious. In my experience, it's rare for patients to fully recover from an operation and then develop symptoms from a stump neuroma. Often, there's an indication of potential stump neuroma development if the patient isn't recovering normally. With open surgery mild to moderate discomfort may persist for up to six months post-surgery, and the full results of surgery can take up to a year to fully realize due to scar tissue remodeling and the foot adjusting to the absence of the nerve. I have not encountered evidence of a stump neuroma with either cryosurgery or radiofrequency to date.
Been suffering with a neuroma on my right foot and a bunion on my left. 😅 Needless to say I wanted to run my first half marathon this year and continue hiking and backpacking but my feet are killing me.
I think it’s this one. shoemed.co.uk/products/xsensible-stretchwalker-swx6-cognac?variant=39774911889494¤cy=GBP&gad_source=1&gclid=Cj0KCQiA2eKtBhDcARIsAEGTG41kqN2Xbg0tQ_T-x9JxmqcYHEfNEz8PZVPv5TTzh7K14tEo9xISwnEaAjEIEALw_wcB
shoes are supposed to be foot shaped aka wide toe box. Shoes are supposed to be flexible. Shoes should not have arch support and/or have any type of cushioning. Shoes should be zero drop from heal to toe. example - Vivobarefoot, bohempia, feelgrounds, zero shoes, sole runners etc
I agree to a certain extent. Indeed, barefoot shoe technology can be highly beneficial for those with strong biomechanics, particularly when running on natural surfaces. However, it’s important to acknowledge the unnatural nature of concrete and other hard surfaces. Expecting the foot to adapt to such harsh terrain without adequate protection might be unrealistic. Furthermore, biomechanical efficiency plays a crucial role in foot health. Issues with foot mechanics can be the difference between sustaining injuries or remaining injury-free. Drawing from my 30 years of professional experience, I believe in the uniqueness of each individual. Accordingly, treatment and advice should be tailored to meet their specific needs and conditions
While Sketchers offer advantages, they may not be the most stable choice for everyone, especially for those with very flat and unstable feet. In such cases, a more stable training shoe, like the Altra Paradigm, might be a better option, provided that the individual has sufficient ankle flexibility. This variability in foot structure and needs is why I advocate for personalized shoe recommendations. There isn’t a one-size-fits-all solution in footwear, as each individual’s requirements are unique.
They certainly set off my planar fasciittis a few years ago, and I'll never wear them again. Morton's neuroma though is really caused from arch collapse. Certain shoes will only make it worse.
It’s all about weighing up the pros and cons. The obvious approach is to try the safest approach with the least risk of complication. I perform open surgery when necessary, but by minimising the number of open procedures I do, choosing minimal invasive approaches whenever possible, I keep my complication rates very low. Open surgery, works for the majority of patients, but if you have a complication like stump neuroma it can be very challenging to manage.
happy to see you in London, but I appreciate that might not be practical. I can recommend the following Dr in the USA. orthopedic.io/podiatrist/dr-peter-a-wishnie-dpm-piscataway/
Yes, in some cases, Morton’s Neuroma can improve without targeted treatment, depending largely on the specific circumstances of each case. The outcome often hinges on factors such as the size of the affected nerve and the extent to which it has become thickened or fibrosed. Typically, a notable lifestyle adjustment is necessary for a chance of spontaneous recovery. For instance, if activities like dance and yoga, which are known risk factors for Morton’s Neuroma, are a regular part of your routine, ceasing these could potentially allow the condition to resolve on its own. Similarly, occupational factors can play a role. If your job involves prolonged periods of standing in high heels, a shift to a role that allows for more comfortable and foot-friendly footwear, such as wide shoes could lead to significant improvement. This adjustment could give the nerve the relief it needs to recover. In my professional experience, appropriate guidance and advice can sometimes be all it takes to alleviate symptoms. However, it’s important to recognize that for many individuals, making such radical lifestyle changes isn’t always feasible or practical. Each case of Morton’s Neuroma is unique, and what works for one person may not be suitable for another.
Regular runner - had symptoms of Morton’s neuroma since early Feb 2023, been testing different orthotics/metatarsal dome configurations and still discomfort both in road(new balance shoes) and trails(Hokas). Recently had a steroid injection and pain in the neuroma location(underneath 3/4 toe) has gone from a 2/10(general movement) +5/10(exercising) to a 6/10(general movement) +9/10(exercising) I’ve got 4 ultramarathons booked for 2024 and really don’t want this issue to stop me in my tracks as I never knew how common it was - any advice?
For some people, a steroid injection will last longer than others. If the problem is due to a lot of inflammation around the nerve, rather than thickening, there is more chance it will work longer term. Try and vary your terrain as much as possible. Take a look at some of my other videos for things to try. Consider ToeToe socks which can help.
I read finding shoes like foot shaped may help since they allow the toe spread. I have Roman type feet and developed this condition along with that foot pad is always sweaty, End of the day the area swells so it feel like socks are crumpled and new socks and or inserts help. Hoping the sketchers will help but will memory foam work since told need good arch support?
Yes, this is a valid consideration. That's why I've suggested a variety of footwear options. If your foot tends to pronate and lacks stability, a shoe offering enhanced support is advisable. For instance, the Asics Gel Kayano is an excellent choice. Alternatively, a shoe, such as a Sketcher, may suffice if paired with a quality orthotic. A skilled podiatrist can create a custom orthotic that includes memory foam for added comfort. Regarding excessive foot perspiration, regular use of a potent foot deodorant is recommended. It's crucial to keep the areas between your toes dry. Additionally, there are commercially available devices that pass a mild electric current through the feet to significantly reduce sweating. These devices have proven to be highly effective.
I think I maybe having this procedure soon 2 injections haven't worked and the pain is intense. My local foot specialist cant do this procedure, and I think I'd rather have this solution than have open surgery.
I would agree that it’s always best to start with the least invasive and safest procedures. Open surgery can work well, but leave it as your last option because of the risk of complication.
Putting heel lifts in the Altra shoes creates another problem. The shoes are shallow in the heel area to begin with. The heel lift then causes the foot to sit too high and come out of the shoe with each step. I've tried Brooks, New Balance and so many others and the ones that work best for me are Orthofeet.
Many thanks for feedback. Yes this can be a problem. Especially if your heel is a certain shape. There is a special lacing system that can help to keep the heel back and secure and I will show this in one of my next videos. The other option is that the Altra has quite a good insole that you can remove. if you replace it with a thinner one, then you can add some heel lifts and your foot will be slightly lower in the shoe. However the reality is that not all shoes work for everyone. I’m glad you found a solution with the ortho Feet. This shoe is not as stable as others, but we are going to do more testing as it does have some interesting features.
Very sorry to read this. I don’t believe Professor Wishnie is too far from you and he has a very good reputation. Maybe he can help. Link: raritansurgery.com/physicians/bio/wishniepeterdpm/ Sorry you are so far from my clinic.
had it done twice, first time had 6 week mod. pain relief, second time about 4 mos., does not cure anything, and 2 other clinics that i contacted had stopped doing it for unknown reasons
I'm truly sorry to hear that cryosurgery didn't bring you the relief you were hoping for. I presume you had it done in the US where the procedure is more common ?It's important to remember that each person's journey to healing is unique, and what works for one may not work for another. This is precisely why we offer a range of treatments. Cryosurgery, while effective for many, isn't a universal solution, and understanding this is key in our approach to patient care. I plan to discuss the various reasons why different treatments work for different individuals in a future video. It's a complex topic, and I believe it deserves thorough exploration. I've seen first hand how cryosurgery has positively impacted the lives of hundreds of my patients. However, I also recognize that it's not always successful, and acknowledging this is crucial in practicing compassionate and effective medicine. Safety is always our foremost concern, especially when comparing cryosurgery to other procedures. Personally, if I were faced with Morton's neuroma, I would choose cryosurgery as my first line of treatment. It allows for continued daily activities and, in my experience, the risk of complications like stump neuroma is extremely low. In fact I have never seen it with cryosurgery. I want to encourage you to remain hopeful. Finding the right treatment can be a journey.
Also been diagnosed with this extremely painful condition I had an injection between 3rd and 4th toe, it didnt work, turns out i was getting pain between 2nd and 3rd toe also - had injection there last week. I think its removed the pain there but defo still have pain inbetween 3rd and 4th toe, I dont really want to be cut open for this. Im worried the specialist is going to suggest this, Im leaning more towards a cryosurgery procedure. I have had ultrasounds and I was shown 2 neuromas 2nd and 3rd one was smaller 3rd and 4th one is 5.4mm. Trying some PT at moment. starting today. This is a horrible problem I can hardly walk with it at the moment
Yes, it can really play havoc with your life, and I'm sorry you're suffering. One of the challenges is that not all neuromas are symptomatic. We often see them incidentally, and it's only if they reach a certain size or level of irritation that they become problematic. That's why you can't rely solely on the scan. It's very much a case of marrying up the scan with the clinical examination. It's not uncommon for practitioners to treat a neuroma that isn't actually causing the problem. I hope my videos are helpful, especially in allowing you to find a conservative solution. The right choice of shoes can really make a significant difference.
Thanks for very helpful video Dr. Im just diagnosed with a Mortons Neuroma between 4th and 5th metatarsal in left foot by a 2nd podiatrist. I didnt have any imaging. They are treating me with laser, an orthotic is ordered. Foot is padded whilst waiting for orthotic. Brooks Ghost neutral runners were recommended. I wear these indoors all the time. Now my perfectly working other foot is playing up. It feels like it has been stretched (sore at the heel and on the sole). I have deduced its the Brooks. What else could it be? I tried explaining it to the podiatry team but they dont agree its the shoe. It cannot be from exercising as Iv only just started them in last few days. That foot is nearly worse than the Morton's Neuroma one now. I cannot walk in the Brooks even though the left foot feels ok in it. Wondering have you heard of this happening to the opposite foot with new shoes.? Any help appreciated as Im at my wits end!! thanks
Thanks for comment. Morton’s Neuroma rarely occurs between the fourth and fifth toes, a situation I’ve seen only twice in 30 years. Confirmation via ultrasound is essential. The Brooks Ghost Trainer suits a neutral foot, but effectiveness varies with foot type. If orthotics and shoes aren’t helping, alternative treatments should be considered. Our lab’s detailed orthotic analysis, using hundreds of sensors, could offer more insight. Given your current discomfort, a review of your orthotics and possibly a different shoe type might be beneficial. For more detailed advice, please feel free to contact our practice - 02082979631. Good luck !
thanks very much, so an ultrasound rather than an MRI?? I plan to go to my GP soon with this for a definite diagnosis (Im in Ireland)@@MortonsNeuromaCentre
I did not even develop a Morton’s neuroma until I started wearing Brooks Ghost. It could be a coincidence but they now cause more pain that any other shoe.
Thank you for your video. I wish you worked for the NHS . I waited 4 months for a physio appointment to be told ignore the numbness and not worry about it! I recently went to see a private physio who so far has been very helpful in Cambridgeshire. I wanted to buy Sketchers but l am unsure which ones to buy .
Doc! Can’t tell u how bad I need these videos. I’ve lived with this for SO LONG, positive it’s Morton’s Neuroma and not able to have surgery due to no health insurance.
Hi there. The symptoms have to fit. One way is a local anaesthetic diagnostic injection. if you block the pain temporarily with local and it goes then it must be the neuroma. ! If it stays, its something else. Also the clinical exam will generally tell you.
