Pain in the forefoot (text is reposted from the equipment thread)



jerr-man

New Member
Dec 23, 2010
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I originally posted this thread in the equipment section, but now think it might be more appropriate here.


My main issue is I have Morton's Neuroma on my left foot that causes hot spots and eventually pain after riding more than 20 - 30 miles or so (my pain-free mileage may vary). I have had physical therapy and cortisone injections with limited success. I am currently using a combination of holistic anti-inflammatory tablets and creams that appear to have made the pain slightly more bearable.


Quote: Morton's neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. Morton's neuroma may feel as if you are standing on a pebble in your shoe or on a fold in your sock. Morton's neuroma involves a thickening of the tissue around one of the nerves leading to your toes. In some cases, Morton's neuroma causes a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb. Morton's neuroma may occur in response to irritation, injury or pressure. Common treatments for Morton's neuroma include changing footwear or using arch supports. Sometimes corticosteroid injections or surgery may be necessary.


One solution I found to ease the pain/pressure was to add varus wedges into the shoe (under the insole). This has helped reduce the pressure on the painful area, but not completely. One observation I have made relatively recently is that my foot prefers a bit more room in the toe box (so I can wiggle my toes) and reduce any excess pressure on the forefoot area that hurts.

Now that my shoes have a few thousand miles on them and are starting to show some signs of wear, I am looking for advice on my next shoe from the user community. I am currently riding on Crank Brothers (Quattro TI) Road Pedals and Specialized BG Pro Carbon Shoes. Does anyone else have a similar issue? What have you done to reduce the discomfort? What shoes are you using? Pedals? Are custom shoes/foot beds my best solution? Any and all recommendations are appreciated.
 
I don't think they are available anymore - at least not in my size. I only see it on Performance and Nashbar.
 
I have had Morton's Neuroma for the past 10 years.

I had success with my podiatrist using Sclerosing injections instead of cortisone. Perhaps I was just fortunate that the 6 injections every other week worked for me during the first series that I did not have any problems for 5 years before having to go in for another 6 injections last year.

This time around the injections were not quite as effective, but I am doing a lot more training and putting a lot more stress on my feet.
I use Specialized cycling shoes since they seem to have a wider toe box and the LOOK Keo pedals seem to give enough area to distribute the pressure. My right foot will start to feel slightly discomforted on a 100 mile ride, but that is way better than it was before the injections.

My podiatrist did tell me at the finish of the last treatment the next time I will have to get surgery so I am hoping that I do not have another serious flare up anytime soon.
 
Thank you for your response and details. I just googled the sclerosing treatment and will have to look into and consider medical intervention at the appropriate time.

Did you try a lot of pedals before arriving at the LOOK Keo? I decided on the Crank Brothers Road pedals (after using spd mtb pedals) because they are easy to walk in.
 
I did not have the funds to try out various pedals, but mainly looked at the toe box of the shoe, stiffness of the sole (stiff like carbon) and a pedal platform that would not pinpoint pressure on the metatarsal. If I remember the CB road pedals also have a good platform. I used CB egg beaters on my mt. bike and I can feel those, but I usually do very short sessions on the mt. bike so it does not tend to do much harm.

I believe most cleats and pedal systems will be okay if the sole is stiff. Since you are already using Specialized shoes I think that part is covered. I don't think you will find a better shoe for the condition we have. I do not use any sort of inserts since I tried those before and it made it worse for me.

Best wishes on finding the solution for you. I have been there and have experienced enough pain to where I struggled to walk. The injections seemed to help me the most, but as you can imagine those shots of alcohol near the nerve will just about make you rip the arm rests off the chair while being administered, but walking out of the office it would be instant relief.
 
Just a bit more background to my condition (and why I think the varus wedge works for me).

It appears my neuroma arose as a result (partially?) of having flat feet. Because I overpronate it shifts the way my foot falls (when not wearing a proper orthotic?) and causes pressure on the area where the neuroma formed. It started bothering me, most likely, because I got a dog and started jogging/running with him. It probably doesn't help that I also have done quite a bit of hiking and biking of course. The problem first came to my attention as hot spots after riding for 15-20 miles.

The varus wedge seems to better distribute the pressure on the ball of my foot, taking some of the pressure off the neuroma.
 
Well, here I am many hundred (1200+) miles since I last posted about this topic. . ., still riding the same shoes, which are now looking more ragged (especially the heel section of the left shoe).
Still looking for a solution and advice. Shoe fit appears to be something I really need to hone in on.

Does anyone know of any shoe fitters in the New York metropolitan area?
 
I've received a referral to High Gear Cyclery in NJ - Has anyone dealt with them and Eric C. at the Stirling shop?