That pebble in your shoe may be a pebble in your foot. Maybe not an actual pebble, but an inflamed nerve. The feeling may also manifest as a burning or numbing sensation. The plantar nerve, running between the 2nd and 3rd or 3rd and 4th metatarsals, can become entrapped by the transverse metatarsal ligament resulting in subsequent inflammation (Bencardino, 2000).
Causes of Morton’s Neuroma all seem to align with increased forces on the forefoot while in the midstance and propulsive phases of the gait cycle. Such conditions include footwear choice (high heels, compressed toe boxes), Foot shapes (high arches, bunions, hammertoes) as well as highly repetitive activities in sport. All conditions have the potential to reduce toe extension, which naturally allows a more optimal dispersion of forces throughout the foot.
Phases of treatment include:
- Rest/Activity Modification
- Restoration of foot mobility to alleviate pressure on the nerve
- Strengthen and correct movement of local structures
- Integrate into complex movements
A local corrective approach may include:
- Standing straight leg calf stretch
- Toe extension stretch
- Bent leg downward dog
- Resisted ankle inversion
- Calf raise
Following the local approach, integrative movements can be incorporated under varying load and speed:
- Ankle Inversion Resisted Split squat
- Hip airplanes
- Marching and skipping variations
- Pogo jumps
Book in with one of our Kinesiologists if you need a tailored approach to your rehab!
Written by Daniel van Woerkens
Bencardino, J., Rosenberg, Z. S., Beltran, J., Liu, X., & Marty-Delfaut, E. (2000). Morton’s neuroma: is it always symptomatic?. American journal of Roentgenology, 175(3), 649-653.
Morton’s neuroma. (2019, February 12). Retrieved February 12, 2021, from https://www.mayoclinic.org/diseases-conditions/mortons-neuroma/diagnosis-treatment/drc-20351939