I am posting the following as a public service to the cycling community. In particular it is to give back for the help I have received from an unnamed member of the BF community who has provided tremendous insight if not moral support for this frustrating malady. I have Morton’s Neuroma in my right foot and am trying to cope with it. I have been blessed in my life with great health and this has been a daunting setback to say the least. Most of us are very focused on being healthy and why we choose the cycling lifestyle. Sometimes there is an elusive balance between breaking down our bodies and becoming stronger. It is analogous to carpal tunnel of the foot brought on by repetition and improper mechanics. I accept responsibility for it…mostly due to my fault of subjecting my feet to poor mechanics which I have learned about through my injury. I am somewhat of a careful guy by nature and don’t ride excessive miles and it is almost ironic that me of all people would be stricken by a mechanical issue because I am pretty focused on cycling biomechanics but none the less the case. There are warning signs that you should be made aware of. If you deny these, you will likely develop a chronic condition like I have if you subject your feet to the high repetition of fitness cycling which can affect not only your cycling but ordinary life as well. I touch upon some of this below.
Numbness: Don’t deny it. If you have it…make a change…now. It is a precursor to nerve damage which is what a neuroma is.
Shoe Toe Box: Wide and unfettered is what you want. You do not want the metatarsal heads…the landing pads for the front of your foot…smashing together. This promotes a neuroma.
Foot Pressure: Your arch has to bear some of the load for two reasons:
1. Takes some of the pressure off the metatarsal heads.
2. The foot is a suspension bridge. If the bridge sinks in the middle the metatarsal heads converge and cause damage. The nerve responds by growing sheathing around which increases its size setting you up for further pain.
Pedal mechanics: If you pronate, the metatarsal heads will crash into one another. Pronating is mostly caused by an unsupported arch. Support the arch with a proper orthotic or shoe floor shape and you will not tend to rotate your foot inward inside the shoe which causes the forefoot to be concave and smashes the metatarsal heads together. Perhaps you see a trend emerging
What are the options?
I am going through this right now. Conservative treatment at first of course. Many I believe don’t solve a foot neuroma because they don’t address the root cause. You have to change your habits in your daily life and in your cycling. If you don’t, I don’t believe a neuroma will ever go away and in fact will grow much worse and you will be debilitated by it including your daily life of walking and standing.
Foot wear:
If you own a lot of shoes, get rid of all shoes that scrunch your toes together or have them stretched by your local shoe repair. Add an orthotic or metatarsal pad to all you shoes to separate the metatarsals.
Cycling:
I am loath to return to cycling shoes. I love cycling dearly and rode last night 35 miles with my friends averaging over 20 mph for a few miles. I am a decent but not a top cyclist. You not only have to change your footwear but how your foot is loaded. Not sure if you have heard about this trend but some believe and I am coming to this school of thought through trial and error and necessity that arch cleat or pedal positioning versus spindle over the ball of the foot is the way to ride a bicycle if you choose to clip in or not. One thing for sure, if your forefoot is injured as mine is, this is the "only way" to ride a bicycle. I have not lost any power as a result. In my case I have sidelined my Look KEO pedals and am riding large platform pedals and Nike Tennis shoes with generous arch support that are wide in front. I position the arch of my foot right over the middle of the pedal.
Here is some convincing reading about arch positioning of pedals.
http://www.serotta.com/forum/showthread.php?t=31187
http://forums.roadbikereview.com/showthread.php?t=95068
http://bartmangbikestowork.blogspot..../mid-foot.html
I am also coming around to the Grant Peterson school when it comes to clipping in. Don’t get me wrong, given a choice, I would clip in but many report hot spots with cycling shoes that if not fit properly will damage your foot as they do not flex.
If your hard sole cycling shoes do not agree with the shape of the bottom of your foot…you are setting yourself up for injury…what happened to me.
I wanted to put this out to heighten awareness. Six months ago I had never heard of Morton’s neuroma and I am finding out is extremely prevalent in runners and cyclists and other athletes that disproportionately load their fore foot improperly. My neuroma is getting better mostly by changing my foot mechanics, anti-inflamatories…no cortisone yet….and repeated icing. I am trying to avoid surgery at all costs. If you have hot or numb feet, I strongly urge you to study your foot mechanics and/or have an expert help you to prevent serious debilitation. No doubt foot neuromas have a genetic pre-disposition component but I am in camp that we break down our bodies mostly due to our own fault….from tennis elbow due to throwing too many curve balls…to the dilemma of a secretary who develops carpal tunnel and yet must continue to type to make a living.
Safe and healthy riding.