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Old 07-14-11, 11:03 AM   #1
Journeyman
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foot pain - neuroma / pinched nerve, are new shoes the answer?

I've had a pinched and swollen nerve in the middle of my right foot for about two years now. Kept thinking it would go away eventually and it hasn't, consulted a podiatrist last week.......he injected alcohol into the sensory nerve but it didn't help for long. Plan B is to have the nerve removed surgically this winter? Can anyone offer any feedback on a similar problem? My other concern is why is this happening, my left foot lately feels sore so I am concerned that I may be developing a problem with this foot. I have orthopedic foot inserts inside my shoes, much more comfortable but this hasn't prevented or lessened my current injury? Would new and different shoes make a difference? Shimano SPD's currently, if so are there any types of shoes available that may help avoid similar injury?
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Old 07-14-11, 11:05 AM   #2
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Possibly wider shoes? Lake makes them in widths as well as Sidi and possibly some others.
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Old 07-14-11, 11:29 AM   #3
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Make sure the shoes are not too tight, possibly convert to road-style shoes which will have a stiffer sole. Alcohol injections? Have you gotten a second opinion? Personally, I don't have much respect for podiatrists. My one experience with them was bad; the quack mis-diagnosed the problem which led to prolonged and excessive treatment that didn't work. Convenient for him, but not for me.
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Old 07-14-11, 11:34 AM   #4
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Was your problem diagnosed as Morton's neuroma?

I had this problem a few years ago and switching to Specialized or Sidi cycling shoes solved my problem. They both seem to have the padding needed to relieve pressure on this area of the foot.
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Old 07-14-11, 03:15 PM   #5
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You may want to try some of the Specialized shoes. Mine are so comfortable that I would wear them all day long if they would bend. I have the MTB Sport which cost me $92.00, but I've seen them in the 80's. Never tried the Sidi brand as they are more money than I want to spend on cycling shoes right now.
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Old 07-14-11, 04:05 PM   #6
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You may want to try some of the Specialized shoes. Mine are so comfortable that I would wear them all day long if they would bend. I have the MTB Sport which cost me $92.00, but I've seen them in the 80's. Never tried the Sidi brand as they are more money than I want to spend on cycling shoes right now.
No need to buy the Specialized shoes... you can buy the insoles separately. They have helped me a lot.

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Old 07-14-11, 10:44 PM   #7
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If you have Morton's there is lots of info on the net and plenty of posts on BF on the subject. I have had it for several years. A shoe with a little more toe box room may help some. Very surprised that Sidi was recommended. They make great shoes but the Italian last is quite narrow in the toe box. The 2 brands which work for me are Diadora and Gaerne.

One thing that has helped some is: find a store that caters to runners, not Dick's or a mega sports store, but one that is a specialty store. There are several brands of heat moldable foot beds that are a bit thicker than most insoles that come with cycling shoes. I like Archmolds http://www.archmolds.com/insoles/pro...products_id=28 and use the Striker and Maximum depending on which shoes I am using.

I have read that the surgery method of resolving this issue has a fairly low success rate. Unless the pain is unbearable see if some other methods work before taking that action.
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Old 07-15-11, 07:10 AM   #8
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I have Morton's. The pain was almost unbearable so my doctor gave me a cortizone injection but it took a while to take effect. In the mean time I went to the podiatrist. He confirmed the diagnosis and said he would do surgery in about six weeks when the injection wore off. Many months later I'm still pretty much pain free. Of course one of my toes is almost totally numb. Must have been a good shot. New Balance makes some good shoes for this condition. They have a wider toe box and are available as a walking shoe or a more athletic style. They have a very good website. And sandals are a no no for me. The lack of support causes a lot of trouble. Good luck with your problem.
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Old 07-15-11, 08:58 AM   #9
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Yes, its Mortons neuroma in my right foot. After my evening ride yesterday a lot of pain in this foot, even pain last night while trying to sleep. I've had Specialized insoles for about the last two years. I think they've helped a lot but obviously didn't provide a complete solution. So, yesterday I purchased Diadora shoes..... the Shimano SPD - Sl shoes will be retired once I receive the new ones. My concern is less about treatment for the injury, but more than anything my real concern is about avoiding the same problem with my left foot. My sister used to run marathons but had to quit because of her foot problems, so I want to find some kind of solution that will allow me to continue riding at my current level. I hope the shoes help, the Shimano shoes have always felt fine and seemed to have plenty of room but I have had problems with hotspots in the hotter parts of the summer here in Kansas. I agree about Sidi shoes, my impression is they are generally pretty narrow. I'll also check out the running insoles. Its interesting that the swelling on my foot is almost directly under the cleat, I think that where this injury occurs to begin with.
http://www.mayoclinic.com/health/mor...SECTION=causes

Last edited by Journeyman; 07-15-11 at 09:11 AM. Reason: additional link - mayo
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Old 07-15-11, 10:09 AM   #10
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The nerve runs between the bones, and once it swells there's no room for the swelling. The cortisone injection will help to reduce the swelling, but you also need to ice your foot for 20 minutes on and 40 minutes off to help reduce the swelling. Oral anti-inflammatories will help also (aspirin, ibuprofen, etc).

Have you put on weight? If yes, this is putting more pressure on your foot and causing the foot to pronate more than normal, so if you take the weight off then the problem should go away.

Make sure you have a nice wide toe box so that your foot isn't being squished, and this goes for all your shoes.

Pedal float may help as your foot can move around a little more and may take some of the side pressure off. A good set of wide pedals to support your foot is also good.

Several cortisone injections should help you, but if it doesn't go away the podiatrist will do a simple surgery and remove the swollen nerve which will then stop the pain. I've had several incidents of Morton's Neuroma and they were very hard to get rid of, but I just kept doing the injections, icing, and doing message to allow the swelling to be pushed out and it seems to have helped. I'm overweight due to other injuries, and this is when the neuromas start, but as soon as I lose the weight the problem goes away, so don't give up, just be aggressive with the therapy and it should go away. If you don't want to trust the podiatrist, see if you can find a good SPORTS orthopedist who works on feet and get a second opinion. If you have a university near you, see if they have a bicycle racing team and see who they use for their foot problems and go see that person because these doctors are usually more sports oriented and know how to get you back on the road ASAP, and don't forget to do what the physical therapist tells you to do!!
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Old 07-15-11, 10:16 AM   #11
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Try riding without socks? Helped my foot comfort out immensely.
The Bontrager shoes I have are amazingly wide and I have very wide feet. E-sole insoles are awesome. They come with them.
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Old 07-15-11, 10:51 AM   #12
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Keep in mind that the insoles inserted in your shoes will break down over time. What were once comfortable shoes may start to feel less so as this happens. I've replaces insoles in my favorite shoes twice in the last five years. Each time, I noted a vast improvement in comfort.
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Old 07-15-11, 07:50 PM   #13
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I tried all the conventional treatment for a couple of year, cortisone shots, high-priced custom orthotics, anti-inflammatories, wide toe boxes, etc. I finally gave up and went for the surgical removal of the nerve. Ever since, I have a dead spot on my foot that feels like a big wad of my sock under it. Not really painful, but never really comfortable either. Between that and the orthotics, the spring has pretty well gone out of my step. Over the last two years, I have gradually worked up to being able to walk seven miles without blisters or severe pain. I used to walk ten or more miles at least once a week.
I would consider the surgery a last resort, after nothing else helps.
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Old 07-15-11, 08:09 PM   #14
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Originally Posted by Journeyman View Post
Yes, its Mortons neuroma in my right foot. After my evening ride yesterday a lot of pain in this foot, even pain last night while trying to sleep. I've had Specialized insoles for about the last two years. I think they've helped a lot but obviously didn't provide a complete solution. So, yesterday I purchased Diadora shoes..... the Shimano SPD - Sl shoes will be retired once I receive the new ones. My concern is less about treatment for the injury, but more than anything my real concern is about avoiding the same problem with my left foot. My sister used to run marathons but had to quit because of her foot problems, so I want to find some kind of solution that will allow me to continue riding at my current level. I hope the shoes help, the Shimano shoes have always felt fine and seemed to have plenty of room but I have had problems with hotspots in the hotter parts of the summer here in Kansas. I agree about Sidi shoes, my impression is they are generally pretty narrow. I'll also check out the running insoles. Its interesting that the swelling on my foot is almost directly under the cleat, I think that where this injury occurs to begin with.
http://www.mayoclinic.com/health/mor...SECTION=causes
Interesting... my hotfoot nearly always occurs in hot weather when my core temperature rises. Let us know how the new shoes work out. What model did you get?
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Old 07-16-11, 09:07 AM   #15
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Waldowales, I'd be interested to know was the nerve they removed in your foot a sensory nerve only? Your post concerns me I certainly don't want to have a surgery that would change the way my foot works? Billydonn, I bought the Diadora Aerospeed 2.
The hotfoot for me only occurs on hot days on the longer rides, 40 plus and usually towards the end of the ride. I am determined to take better care of my feet, I hope some of what I've learned here will help me.
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Old 07-16-11, 07:19 PM   #16
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Waldowales, I'd be interested to know was the nerve they removed in your foot a sensory nerve only? Your post concerns me I certainly don't want to have a surgery that would change the way my foot works? Billydonn, I bought the Diadora Aerospeed 2.
The hotfoot for me only occurs on hot days on the longer rides, 40 plus and usually towards the end of the ride. I am determined to take better care of my feet, I hope some of what I've learned here will help me.
Exactly how it works for me! But it sounds like your foot pain does not go away when you stop pedaling and cool down. Mine does. And a few minutes off the bike allows me to continue my ride for a while until I have to stop again. In cooler weather I do not get the problem. Are the new shoes road shoes? Let us know how you come out.
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Old 07-17-11, 09:48 PM   #17
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I had a similar problem, and now put a small was of cotton between the two toes that were giving me trouble. It has done the trick. No numbness, hot spot trouble flares up much later than before, and is less intense.
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Old 07-18-11, 09:28 AM   #18
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BillyD, the hotfoot hasn't bothered me for awhile but when I was having problems with this I'd have to stop riding and remove my shoe.....then continue riding. After I purchased the insoles this problem didn't seem to be much of an issue. I think the shoe companies need to provide us with a better design, an ergonomic well ventilated shoe would be welcomed by me. Yes, the Diadora are road shoes.
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Old 07-18-11, 10:56 AM   #19
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I'm suprised I haven't seen the cleat position solution... Move your cleats back (towards your heel) a bit and that might help. It has helped me a ton. This effectively moves the pressure from the pedal/cleat behind the problem area a bit.
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Old 07-18-11, 10:57 AM   #20
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I'm suprised I haven't seen the cleat position solution... Move your cleats back (towards your heel) a bit and that might help. It has helped me a ton. This effectively moves the pressure from the pedal/cleat behind the problem area a bit.
Also recommended by some well-known fitters to increasse glute power during pedaling.
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Old 07-18-11, 01:26 PM   #21
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The hotfoot for me only occurs on hot days on the longer rides, 40 plus and usually towards the end of the ride. I am determined to take better care of my feet, I hope some of what I've learned here will help me.

I also have a neuroma, on my left foot and have the same problem in hot weather. Basically I can't get rid of the pain altogether, after 30 miles its there whether I like it or not but I can relieve it by flexing my toes inside the shoes or taking the foot out of the pedal and relaxing it a bit or trading off which foot I clip in or unclipped or even just stop and take off the shoe for a moment. I have found loosening the strap across the shoe on hot days to help as well. I wear Sidi's and just loosen the two straps across the toes abit. You probably also know about getting a different pedal/cleat will help (and adjusting the cleat properly). It took me afew but I have finally settled on one (Time Atac). My neuroma started when I first began using Speedplays... the cleat and narrow platform pedal damaged the nerve in my foot; the Atac is wider and sortof spreads out the pressure.
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Old 07-18-11, 03:07 PM   #22
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Pinched nerves and neuromas are very different.

If it's a neuroma, get it surgically removed. My wife had a neuroma, and after it came out she felt like she was dancing on air.
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Old 08-15-11, 12:14 PM   #23
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Make sure the shoes are not too tight, possibly convert to road-style shoes which will have a stiffer sole. Alcohol injections? Have you gotten a second opinion? Personally, I don't have much respect for podiatrists. My one experience with them was bad; the quack mis-diagnosed the problem which led to prolonged and excessive treatment that didn't work. Convenient for him, but not for me.
Humm, blazingpedals--judging an entire profession from one contact with one physician. I don't know what you do for a living, think about the same judgment.
I am a licensed Podiatrist for 15 years and treat neuromas every day, cycle about 100-150 miles a week and yes I do have a neuroma that will give me problems once in a while. My partner is not cutting on me yet.
First, do not have your neuroma excised until you have tried all options. Regrowth of an neurectomy is about 15% and can leave you worse off. Isopropyl alcohol injections 6% (I also use a small amout of short acting corticosteroid) are 80-85% successful, but may require 4-6 of them. You may also try infrared laser treatment, cryotherapy, or prolotherapy (I am using infrared). A small neuroma pad in the cycling shoe is helpful, but functional orthotics may not help in a cycling shoe (you are not walking in the shoe). The other replies have also been great. Wider cycling shoes like sidi mega or lake wide (X at the end of the model number). Move the cleat back all the way in the arch, then move it forward until you feel the neuroma pain, then back it up 3-5mm. Also try a stiff sole with a wide cleat platform like Look or Shimano SPD-SL. The small spd mtn cleat can focus pressure directly under the neuroma. Good luck, be patient and give it time.
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