Climbing Foot Pain-Morton's Neuroma

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Karl Baba

Trad climber
Yosemite, Ca
Topic Author's Original Post - Feb 7, 2008 - 03:07pm PT
Hey Folks

Just a warning to take care of your feet and beware of Morton's Neuroma

http://www.footphysicians.com/footankleinfo/mortons-neuroma.htm

Women who wear tight shoes or high heels often get it but guess who else wears tight shoes.

Never use your precious feet to stretch too tight shoes. Buy a 2 way shoe stretcher like this one

http://www.footsmart.com/P-FitRight-Two-Way-Shoe-Stretcher-90120.aspx

Or get your local cobbler shop to do it on their machine.

Use this thread to share your experience or bump it unless a lot of folks have seen this info. It will make a bummer of your approach marches if you get it.

Peace and love

Karl
Karl Baba

Trad climber
Yosemite, Ca
Topic Author's Reply - Feb 7, 2008 - 03:48pm PT
from the Mayo Clinic

"A neuroma is a noncancerous (benign) growth of nerve tissue that can develop in various parts of your body. Morton's neuroma occurs in a nerve in your foot, often between your third and fourth toes. The condition isn't a true tumor, but instead involves a thickening of the tissue around one of the digital nerves leading to your toes. Morton's neuroma causes a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb if you have Morton's neuroma.

Also called plantar neuroma or intermetatarsal neuroma, Morton's neuroma may occur in response to irritation, injury or pressure such as from wearing tightfitting shoes. But Morton's neuroma may also occur for unknown reasons.

Treatments for Morton's neuroma commonly involve changing footwear, resting your foot, and using arch supports or pads to help take pressure off the area. In some cases, your doctor may recommend anti-inflammatory drugs, a cortisone injection or even surgery if you have Morton's neuroma."

http://www.mayoclinic.com/health/mortons-neuroma/DS00468/DSECTION=1

Peace

karl
Karl Baba

Trad climber
Yosemite, Ca
Topic Author's Reply - Feb 7, 2008 - 09:30pm PT
LEB, I know you don't know much about this, but when has that ever stopped you? Post up baby!

Love

Karl
WBraun

climber
Feb 7, 2008 - 09:34pm PT
A message from your friendly Podiatrist Baba .....
nick d

Trad climber
nm
Feb 7, 2008 - 09:41pm PT
That bad pain in the ball of your foot could also be a broken sesamoid bone. I have one and it is likely I'll be stuck with it for the rest of my life. Either way, bummer!
Mtnmun

Trad climber
Top of the Mountain Mun
Feb 7, 2008 - 09:44pm PT
I have it, I posted about this a few weeks back. Matisse and others had some good advice. After riding my mountain bike over an hour on rough terrain, it feels like someone put a hot knife in my foot. Here is the previous thread.

http://www.supertopo.com/climbing/thread.html?topic_id=481596&msg=481694#msg481694
Crimpergirl

Social climber
St. Looney
Feb 7, 2008 - 09:52pm PT
Too late here too. Painful little devils. Fortunately mine flares up only occasionally. But when it does - yelp!
Karl Baba

Trad climber
Yosemite, Ca
Topic Author's Reply - Feb 7, 2008 - 09:56pm PT
Opps, didn't realize somebody already posted about it.

Peace

karl
Karl Baba

Trad climber
Yosemite, Ca
Topic Author's Reply - Feb 7, 2008 - 10:21pm PT
Actually, I know enough about this problem now, I'm just trying to alert other climbers who might feel the pain and not know what it is.

I'll post this in the other thread to (sorry to bump it) but nobody mentioned one of the best treatment which is a series of Alcohol injections at the site.

http://www.biomech.com/db_area/archives/2002/0204.painmana.bio.shtml

http://www.nbwebexpress.com/achieve_more/neuroma/neuroma_print.asp

Injection Therapy: The two common agents used in injection therapy of neuroma are corticosteroid/local anesthetic and alcohol sclerosing agent. Corticosteroid is injected around the nerve to decrease the inflammation and reduce fibrosis or scaring. Greenfield found that 30% of patients undergoing corticosteroid/local anesthetic therapy had complete relief of symptoms and 50% had partial relief [4]. Alcohol sclerosing agent is a dilute mixture that includes a small percent of alcohol and a numbing medication. The alcohol is injected around the nerve in hopes of reducing its size. The therapy involves a series of 3-8 injections with 5-10 days between injections. Dockery found an 89% success rate using this method of injection therapy [5].

I mainly wanted Lois to keep my thread bumped until folks saw it but I see we've discussed it recently

Peace

Karl
stich

Trad climber
Denver, Colorado
Feb 7, 2008 - 11:01pm PT
A very nice girl named Amy that works at a local gym has a neuroma. I'll have to tell her about the alcohol sclerosing treatment's 89% success rate. I had only known about the steroid shot before from Crimpie.
Mtnmun

Trad climber
Top of the Mountain Mun
Feb 7, 2008 - 11:23pm PT
No worries on the second post Karl, this is great information.
Sherri

climber
WA
Feb 9, 2008 - 02:33am PT
After years of treating mine with steroid shots, two or three sets of corrective orthotics from podiatrists, and two botched surgeries, I still had neuroma troubles. The thing that finally put a stop to the cycle was a pair of custom orthotics made for me by a local shoe salesman. Go figure.
slayton

Trad climber
Morongo Valley, Ca
Feb 9, 2008 - 04:42am PT
I have worked at a Birkenstock shoe store for the better part of eleven years now. No, they're not just for lesbians. I have seen all manner of foot funk from arthritis to plantar fasciitis to hammer toes and, yes, morton's neuroma. Who is this "Morton" guy anyway?

At the first sign of any lingering foot pain see a podiatrist. Or if there is a good comfort shoe store in your area go talk to them. Bear in mind that the degree required for podiatry is among the least intensive medical degrees. Seek a second oppinion. Do some research. I've heard horror stories.

By far the most common ailment that I have seen is plantar fasciitis, which is usually characterized by a sharp pain in the heel when getting up on your feet after a period of inactivity, very often first thing in the morning. If this is happening, one of the tendons that attach at the heel has torn, maybe just a bit, but enough to cause discomfort.

Probably the second most common ailment that I've seen is Morton's Neuroma, usually characterized by the feeling of a rock or marble under the ball of the foot in one's shoe, often accompanied by a burning sensation. This is nerve dammage already described (and much better than I could) upthread.

Many of these foot ailments can be treated with orthotics (and the wearing of sensible shoes). If you have insurance that will pay for it or the deductable isn't prohibitive, go for it. If you go this route and there isn't some extenuating circumstance, go for a 3/4 length orthotic vs. a full length. They are more versatile and will fit in more of your shoes. Again, seek a second oppinion, and question the hell out of the pedorthist that will actually be making the orthotics.

There are over the counter orthotics out there. Some are good, some or ok, and some are absolute crap. Realize at this point that you don't necessarily need cushoning, you need support. Gel inserts don't cut it. There is a popular brand of orthotic out there called "Super Feet" that are pretty good. Their major benefit is that they offer a bit of medial support. If you are sufferring from plantar fasciitis this . .. might. .. . work for you. The main drawback is the sizing. I don't remember if it's a two or three size format (men's 9-10 or 9-11, etc.. .. .. same for women 6-7 vs. 6-8) the drawback being that, for most of us, our overall footlength usually correspondes to our archlength so with "Super Feet" if it's too long you just cut off the toe end to fit in your shoe. The arch isn't necessarily gonna be where it should.

If you are dealing with something like Morton's Neuroma you will need more support. Among other things. Your foot has four arches: medial, longitudinal, metatarsal, and transverse. Morton's Neuroma is an ailment that afflicts the area between the metatarsal heads of the foot. Usually right between the third and fourth knuckle of he toes. In this case, metatarsal support is crucial. This arch is pretty much right in the middle of your foot (on the bottom of course) and stops just behind the ball of your foot. When this arch is supported with an orthotic (not many shoes that I know of will actially do this) it will feel weird and may take some getting used to. But more importantly, it will lift and spread the metatarsal heads (those pesky knuckles) thereby relieving the pressure on the neuroma. Assuming of course that you are wearing shoes that are wide enough for you particular hoof.

So. . . .. a major disclaimer here, the only over the counter orthotic that I know of (and this because I've ahd years of intimate contact with it, {I wear it every day} ) is the Birkenstock Blue Footbed. Unlike "Super Feet" it is sized for any particular foot and supports ALL of your foot's arches: metatarsal, medial, transverse, and longitudinal.

Will Morton's Neuroma cure itself over time without surgery or shots or whatnot?? I don't know. Probably depends on the case and the severity. But climbing shoes, ballerina slippers, and sexy high heels (that transfer the weight of your body onto the afflicted part of your foot) certainly ain't gonna make matters better.

Jeebus. Did I just write all that? Well, if you're still reading, bear in mind that I am NOT a doctor. Just someone without a degree but with many years experience dealing with feet.

My best wishes for foot health for all. .. ..
leinosaur

Trad climber
burns flat, ok
Feb 9, 2008 - 11:57am PT
I used to get numbness, especially at the distal end of the hallux (tip of the big toe) but not as often, if ever, anymore. Sometimes it would last into the next day after climbing. I wonder . . .

Blinny

Trad climber
NWMontana
Feb 9, 2008 - 12:10pm PT
Years ago, back at the ski area in Mammoth, we sold these hot molded footbeds called "Peterson Footbeds" and I LOVED them. . . my right foot is a ladies 11 and my left is a ladies 9.5 (motocross wreck broke my right foot. . . and made it WAY bigger). . . so. . . I made myself a pair of those footbeds and put them in my telemark boots. . . well. . . over the years they broke down and were toast so I surfed the net trying to find them again. They must be belly up - BUT - I found "Sole" footbeds (out of Calgary and Great Falls, MT). . . and. . . well. . . THEY ARE REALLY GOOD.

http://www2.yoursole.com/

I have 4 pair of them and they live in teleboots, cross trainers, skating boots and classic boots. . . even "borrow" a pair for my UGGS and Sorels.

So. . . if you're looking for something that is heat moldable - that you can do yourself (shops will do them for you, too) these are the ticket. . . and they won't put you in the poor house. Cool thing is, you can re-mold them up to 4 times before they lose their ability to be re-molded.

Got some for TheReal and he HATED them - so I got 'em hot again and made them for myself. (we have the same size feet)

Pretty cool.

Used to have REALLY bad plantar fasciitis AND Morton's and these have fully taken the pain away.

YAY!

eKat
Karl Baba

Trad climber
Yosemite, Ca
Topic Author's Reply - Feb 9, 2008 - 12:45pm PT
Thanks for all the info folk are sharing. Somebody will have less pain in the future because of you

Peace

karl
Sherri

climber
WA
Feb 9, 2008 - 06:42pm PT
Besides the mechanical aspects of foot care(ie--orthotics, shoes, etc), don't forget to address the soft tissue stuff.

Diligence in working on trigger points in the soleus and calf muscles can go a long way toward preventing/alleviating many foot troubles, particularly plantar fascitis. As with many ailments, the real problem often lies far from where the symptoms/pain show up.

Dig your thumbs around deeply in your calves--if you find "hot spots" of pain(you will often instinctively go directly to where they are, without knowing they are there beforehand), good chance that they're trigger points that need to be released...
Crimpergirl

Social climber
St. Looney
Feb 9, 2008 - 06:52pm PT
After reading the thoughts on the insurance thread, I feel compelled to defend my trip to the doctor. I only saw a doctor with my neuroma after suffering with it for about 5 years. The pain had become so bad that I could not put a sock on at all. Too much agony. Only then did I do it.

Please don't think me an insurance-abusing slacker for actually going to a doctor.

:)
Shack

Big Wall climber
Reno NV
Feb 10, 2008 - 12:32am PT
" No, they're not just for lesbians."

Hahahahaha!!


Are you sure?
Mtnmun

Trad climber
Top of the Mountain Mun
May 28, 2008 - 04:53pm PT
I am reporting on my visit to the foot doctor today for my Morton's Neuroma. I learned that rarely is surgery used any more. He gave me a cortisone injection which has a 60% chance of shrinking the neuroma. If that does not work we will kill the neuroma using the alchohol treatment recommended in the article Karl provided. My doc knew the guy who wrote the article and said he was the real deal.

This method permanently kills the nerve. This ends feeling there, avoids surgery and you live pain free.

He also gave me some cool foot pads to stick under my shoe bed to direct the pressure away from the neuroma. I'm looking forward to getting back on my mountain bike.

Cheers,

Jude
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