Morton's foot: causes, treatment and tips on running shoes

Morton''s foot, also known as Morton''s neuralgia, is a medical problem associated with the nerves in the foot and toes, or rather, the oppression of them. It is named after Dudley J. Morton, the American orthopedic surgeon who first described the condition. Morton''s foot is a fairly common complication and can contribute to certain foot problems. Check out the problem with us!

What happens to the foot in Morton''s foot?

This is a painful condition that affects the sole of the foot, most commonly the area between the third and fourth toes. At these points, there is an enlargement of the tissue around one of the nerves leading to the toes. This causes oppression of that nerve, associated sharp and burning pain in the sole of the foot and inflammation forms. You may feel stinging, burning, tingling or even numbness in the affected toes.

Symptoms of Morton''s foot

In the case of Morton''s neuralgia, the symptoms are not visible at first glance, as is the case with hammertoe, for example. When to pay attention, or what does nerve oppression mean?

• Feeling like you're standing on a rock in a shoe
• A burning pain in the sole of the foot, which usually also shoots to the toes
• Tingling or even numbness in the toes
• Frequent appearance of calluses or blisters on the sole of the foot, both after walking and running
• Instability of the foot and ankle due to inability to tread properly
• Relaxation of the foot and pain relief only occurs after removing the shoe

Main causes of Morton''s neuralgia

As we noted above, Morton''s foot is caused by irritation of the nerve between the bones of the toes. The most common cause of this inflammation is excessive pressure on the toes, the nerves between them and the sole of the foot. Certain common activities can cause and contribute to the onset. These include:

• Wearing high heels or very narrow shoes where the toes are pressed together
• Activities that put a lot of pressure on the soles of the feet, which unfortunately includes running
• Occupations that require being on your feet all day
• Certain foot anomalies that affect the proper function of the foot − flat feet, high arches, hammer toes, bunions or the result of foot injuries

What is the treatment for Morton''s neuralgia?

Treatment involves early diagnosis and focusing on the cause of the problem. Taking pain medication may give you short-term relief, but it won''t get rid of the inflammation and running will become more of an ordeal than a joy. As soon as you notice any symptoms of Morton''s syndrome, go see a doctor. The sooner your doctor diagnoses Morton''s and starts treatment, the sooner your feet will get back to feeling good again.

What treatment steps can your doctor suggest to make your next steps pain-free?

1) Change your footwear from narrow to wide

Shoes with a wide construction can relieve pressure on the affected nerve by providing more room in the front and better distributing your weight when you step on them. Get wide shoes for running and casual wear. Very popular nowadays are minimalist shoes or barefoot shoes that simulate walking barefoot. Remember, however, that switching to barefoot shoes requires an adaptation period because you are engaging different muscles than when wearing traditional shoes.

2) Special shoe insoles

Your doctor may recommend wearing a special orthotic insole with what is called a "metatarsal pelota". For running, there are then freely available shoe insoles that provide support to the foot and keep the toes in the correct position.

3) Physiotherapy methods

A physiotherapist becomes your number one partner on the road to recovery. They will give you special massages, focus on soft tissue techniques, help you mobilise your joints and, depending on the severity of the situation, recommend focused shockwave or radial wave treatments to speed up the healing process and relieve pain.

4) Proper exercise

To heal the foot, you need to actively exercise and consistently work with the affected foot not only at the physiotherapist''s office but also at home − stretching, positioning and incorporating sensorimotor exercises. Although it sounds complicated and the hard work will be mostly on you, you don''t have to worry. A physiotherapist will help you with the exercises and correct execution and will make sure that the treatment is moving in the right direction.

5) Kinesiotaping

Kinesiotaping of the foot also has a beneficial effect. A properly applied taping will give support and proper alignment to the transverse arch, thus relieving pain to the bones behind the toes and the nerves underneath.

6) Surgical nerve removal

As a last resort, when pain does not improve even with conservative treatment, surgery is resorted to. This involves removing the affected part of the nerve.

Is there a prevention against Morton''s foot?

Good news − yes, there is! We have a few tips for you:

• Avoid wearing tight shoes or high-heeled shoes often
• Prefer shoes with a wide toe box for plenty of room in the toe area
• Incorporate mobilisation exercises and toe stretches or foot massages into your stretching routine
• As part of your recovery, attend physiotherapy as a preventive measure
• Get adjustable socks that promote foot recovery with toe separators
• Take care of foot care and hygiene, including regular cleaning and checking for any abnormalities

And which running shoes to choose?

Morton''s foot is a phenomenon that unfortunately does not disappear overnight. And let''s face it, no one enjoys running with sore or tingling feet. Choosing the right running shoes in such a case is even more crucial. Which features of the shoes to take into account?

• Wide construction: shoes with a wide toe box give your feet more room and relieve pressure on your toes.
• Larger size: Your running shoe size should be about 0.5 to 1.5 sizes larger than your regular shoes. After a few miles, your foot swells and expands in the shoe and therefore needs more room.
• Lower drop: Drop is the difference between the heel and toe and is measured in millimetres. The lower the number, the more natural the stride the shoe will allow. You don''t necessarily need to run with "zero" shoes, but aim for running shoes with a lower drop, between approximately 4 − 8 mm.
• Optimal cushioning: foam cushioning components in the midsole take care of soft impacts, short of a puff. In the case of Morton''s foot, it is advisable to have running shoes with medium to higher cushioning, for greater comfort.

Top4Running TIP: What does cushioning mean in running shoes and why is it a good servant but a bad master in some cases?