Morton's Foot?

[zia]

Just read a book on trigger point therapy and realized I have Morton's Foot -- very long second metatarsal. I immediately followed the book's recommendation and added a light moleskin pad (maybe 2 mm?) beneath the ball of my first metatarsal, on the bottom of my insole. But... I saw in another post that someone with this condition was looking for a pad significantly thicker. Is that just personal preference, or is moleskin too thin?

Secondly, does the padding help? I have a nearly endless list of leg/foot/hip injuries (PF, stress fractures, knee pain, ankle pain, hip pain -- primarily from running, but biking doesn't help) and am curious how much difference this will make...

[snapdragen]

I just saw a podiatrist this week for excruciating foot pain when walking. I don't have the same diagnosis as you, but close. My doc has me using these:

http://www.ourhealthnetwork.com/store/item.asp?item_id=377

Only I do not put them on the ball of my foot, but back further, same as your moleskin.

[pfunk12]

A few years ago when I was doing a lot of mileage while training for a marathon, I was experiencing a lot of foot pain. I went to a podiatrist and learned that I had Morton's Foot but the pain I was experiencing was from neuromas - in both feet. The pads that the podiatrist gave me were fairly thick - with holes cut out in the middle. To be honest, they didn't help but that's because the neuromas had gotten too big. I used the pads, got cortisone shots, completed the marathon but eventually had to have surgery to remove the neuromas.

I hope the pads that you end up using help ease any pain you have!

[OakLeaf]

That would be me.

They help incredibly well in my walking-around shoes. Yes in pain and trigger points, but most obviously, in balance in everyday activities. I'm still adapting to them in my running shoes, but once I get the size and placement sorted I'm sure they're going to be great.

Molefoam just wasn't nearly enough for me. What you need to do is put your ankle in neutral, see how high your big toe joint is off the ground, and make your pad that thick (taking into account compression of both your foot flesh and the pad itself). One of the sites selling "proprioceptive" insoles has 3 mm and 6 mm sizes. I'm taping and gluing all kinds of stuff inside my running shoes right now :rolleyes: but the mouse pad seemed to be roughly the same thickness as what I have in my walking-around shoes.

[OakLeaf]

You might try experimenting with your walking-around shoes first, as I did. When you're running, the forces just make the chance of injury that much greater if things aren't right, plus you don't really want to stop and make adjustments on your shoes in the middle of a run.

Also, the difference in your ability to balance shows up a lot more in your ADLs than it does when you're moving straight ahead on pavement.

I've found that I want at least some padding under my big toes, in addition to under the joint. Otherwise, it's just too long of a reach for my toe to reach the ground.

I'm definitely giving my body some time for the muscles to re-train themselves, too. I'm not running nearly as short as they tell you to when you're adapting to barefooting, but I haven't done a long run in the pads yet, and unfortunately I think I'm going to have to run next week's half-marathon in my old orthotics. :(

What have you been using up til now? OTC arch supports, custom ones, or nothing?

[zia]

Thanks, OakLeaf -- this is all very interesting. My walk-around shoes are very uncomfortable, and I walk just about everywhere. I'll have to improve those -- they are an old pair of poorly-fitting running shoes.

This morning, I ran for 2 miles in my newly-configured current running shoes. I put a small, 2-3mm moleskin pad under the insole beneath my big toe. I do wear custom orthotics. They are half-sole, and I'd just cut an old insole in half, leaving 1" of overlap at the midsole (probably very bad) so I put a full, flat insole in the shoe and put my orthotic on top of that. The ball of my right foot almost immediately cramped, but relaxed after a mile. I was definitely aware of the moleskin padding, and things felt... different. "Better" will remain to be seen, especially since I have a 10K race on Monday.

I got my first custom orthotics in 1996 after developing a stress fracture on my second metatarsal. I'm on my third pair and am surprised not a single podiatrist has ever mentioned Morton's Foot -- and that every pair of orthotics has focused exclusively on the heel and arch area of my foot, not the forefoot. I was reading "The Trigger Point Therapy Workbook," and when I got to the Morton's Foot section, I felt like was reading about myself. I have all the classic callus patterns, pain in many of the referral points mentioned, and, of course, a freakishly long second metatarsal!

I have been doing much with the Pose method over the past year, which also made me realize how unbalanced I am in regards to my forefoot -- when I deliberately try to land evenly on all my metatarsals (not easy), I notice an **immediate** decrease in pain.

I have my first trigger point therapy session on Friday and I'm very curious to hear what the therapist says about all my self-research. ;)

Yet one more reason barefoot running might be a complete disaster for me. Oh. Well. Somewhere, out there, there's a secret to pain-free legs...

[OakLeaf]

I wouldn't make any changes for your race, but I'd try the padding without the arch support, not with. Assuming you still have the original insoles that came with the shoes? I knew I'd been keeping mine for a reason (other than the fact that I keep everything, no matter how useless). :p

The reason is, what you want to be doing is letting your muscles support your feet, not slamming your arch down on the orthotic, and that's what the pads let you do. They basically let you ambulate using the muscles that you're supposed to be using - getting the points of contact and push-off that a "normal" foot has. That's why the commercial sellers call them "proprioceptive" insoles - which I think is a misnomer, but it's a way for them to distinguish their product from arch supports (and charge you $50-100 :rolleyes:).

I'm really, really looking forward to getting some of these pads inside a pair of Vibram Five Fingers now. I never thought I'd be able to try those! :):)


I'm on my third pair and am surprised not a single podiatrist has ever mentioned Morton's Foot -- and that every pair of orthotics has focused exclusively on the heel and arch area of my foot, not the forefoot. I was reading "The Trigger Point Therapy Workbook," and when I got to the Morton's Foot section, I felt like was reading about myself. I have all the classic callus patterns, pain in many of the referral points mentioned, and, of course, a freakishly long second metatarsal!


Yep, yep, and yep. And all those arch supports alleviated the arch pain and some of the knee issues, but left me with crummy balance and worse Achilles problems, besides not alleviating any of the myofascial issues all up my back body. And you can add physical therapists and orthopedic surgeons to the list of people who never mentioned it to me (and probably wouldn't know what you were talking about if you asked). Why would they tell me to try cutting up an old mouse pad, when they can get me to spend $200+ for orthotics for each pair of shoes, and get my insurance company to spend $700 for a knee brace? :mad: Actually, you can add a very excellent LMT to the list, too - obviously she's just not familiar with this condition, since she was well aware that I need to be doing something with my feet to keep my ankles in neutral and help with all the muscle imbalances. I'm sure she will notice the difference next time I see her though! :)


PS - ask the LMT for help putting your ankles into neutral, standing barefoot. They should be happy to help. Easier to do with a pair of eyes that's (1) not yours trying to look down at your ankles and (2) trained at recognizing a neutral ankle. That'll make it easier for you to figure how tall your pads need to be.

[nscrbug]

I've been using these metatarsal pads in my running shoes, with fairly good success -


http://www.hapad.com/hapadonline/product.php?productid=16155

[OakLeaf]

Under your first metatarsal?

If somewhere else, could they be cut down to fit under the first metatarsal only?

[NbyNW]

I've got this problem, too -- except it's more a case of my first metatarsal being really short, which also leads to the same callusing under the second. I've been using custom orthotics for years, but they don't do a lot for my forefoot mechanics.

Thanks for starting this thread, zia! I think I might experiment a bit with metatarsal pads, too.

[OakLeaf]

I'm curious... are your third metacarpals longer than your second?

Mine are. I wonder if there's a correlation.

[zia]

I'm curious... are your third metacarpals longer than your second?

What's the difference between a metacarpal and a metatarsal? My third is longer than my first... (but not my second).

[Owlie]

What's the difference between a metacarpal and a metatarsal? My third is longer than my first... (but not my second).

Metacarpals are the hand's equivalent of metatarsals. :)

http://en.wikipedia.org/wiki/Metacarpal

[kmehrzad]

I've got Morton's foot, actually feet, and have had surgeries on both feet to remove the neuromas (enlarged nerves). I've gone the orthotics route, had the cortisone shots (several times) then finally begged for surgery. All THREE surgeries helped get rid of the pain; however, had to have scar tissue removed from one foot which had a neuroma 10 yrs. prior.

My dr. told me to stop running and switch to exercises that do not involve pounding the pavement. On my bicycles I don't use clipless pedals; I'm concerned that the pressing of my foot against the pedal in a localized spot would cause pain again, so I use toe clips on my bikes. This works best in my case.

[OakLeaf]

Morton's foot and Morton's neuroma are two different things. Just named after the same doctor.

[zia]

Surprising update: I DID wear my newly-configured shoes for a 10K running race yesterday and... no knee pain! This is the first time in YEARS I have had zero knee pain at this distance. Who would have thought 2-3mm could make such a difference?

Next step: configure my bike shoes similarly and see if I notice a difference on the bike. I never feel like I'm striking the pedals with the entire ball of my foot... hmmm....

OakLeaf, I never thought of putting an insert into V5Fs. Seems counter-intuitive, but I'm tempted. I was passed by a speedy barefooter yesterday and was intrigued. Again.

[ginny]

Hi all, I just noticed this thread and I have a few questions. My second metatarsal is longer than my first, but I seem to have retracted tendons in that toe on both feet that brings the toe more in line with my big toe. It also makes the toe perma-bent. It's also super ugly with a hammerhead appearance. The questions are: do you all experience this premabend as well? Do the pads help stretch the tendons and eliminate this strange bend? Do you have some web reading you can refer me to? I have successfully run short and long distance since I was 13 with very few injuries, but I worry this bend will be more pronounced as I get older and I will begin to have shoe-rub issues. Thanks!

[OakLeaf]

Ginny, I wonder if your shoes are just too small.

For years, I wore shoes that were too small for my toes, just because my toes are so long (all of them), and I wanted/felt I needed shoes that fit my feet, i.e. had their arch where the arch of my foot was.

In the past year and a half I've completely revised my idea of what shoes fit and what don't. One of the things I've done is go from a size 8.5-9 to a size 10.5-11. :eek: My toes have gradually straightened out, and some of my toenail problems are resolving. (Others of my toenail problems have to do with width, not length, and so far I have yet to find a shoe that's wide enough for my forefoot and narrow enough for my heel - another reason I'm seriously eyeing the VFFs.) Seriously, at 5'3" I have the feet of Daisy Duck. :rolleyes:

[NbyNW]

Zia, great to hear that you had a positive result with your run! Looking forward to hearing how it goes with your cycling shoes.

I'm gonna keep an eye out for some metatarsal pads when I'm out shopping this afternoon.

[OakLeaf]

Do you have some web reading you can refer me to?

This (http://www.triggerpointbook.com/mortons.htm) is an excerpt from the book we're talking about.

Google brings you other results.


Wow Zia, that's great! I'm adjusting gradually and unfortunately I don't think it's a good idea to run my half marathon this Sunday in the new pads. There's definitely a big muscle adjustment going on in the shorter runs. I'm not 100% sure I've got the thickness and placement spot-on yet, either.

[KnottedYet]

I wouldn't think you'd need to pad the 1st met head in a pair of VFFs.

Don't forget, "Morton's Foot" is a perfectly functional foot. Entire civilizations had "Morton's Feet" (Greeks, Celts) and they were vibrant powerful cultures. They weren't hobbling around on crippled feet.

What they had were shoes made for THEIR kind of foot. (or sandals/soft shoes) Morton's foot only becomes an issue when you try to cram a long 2nd metatarsal foot into a shoe designed by and for folks with long 1st metatarsal feet.

(and, of course, they weren't constantly exposed to flat hard surfaces, which I still swear are the bane of ALL modern tootsies)

Morton's foot isn't just a longer 2nd metatarsal, it's also a differently shaped cuboid bone so the foot really does move a little differently. It's also a longer foot, so it's easy to develop hammer-toe because of shoes that are too short in the toe box.

VFF are enough like barefoot that I'd think they'd let your foot do its natural thing, unhampered by shoes designed for a different kind of foot. I'd just suggest you start your VFF running on dirt trails or grassy fields so your foot muscles have a chance to wake up and gain the strength to support your mets properly before you start running on hard flat surfaces.

Knot-doesn't-have-Morton's-foot (but does have dropped 2nd met head)

[Jolt]

I wouldn't think you'd need to pad the 1st met head in a pair of VFFs.

Don't forget, "Morton's Foot" is a perfectly functional foot. Entire civilizations had "Morton's Feet" (Greeks, Celts) and they were vibrant powerful cultures. They weren't hobbling around on crippled feet.

What they had were shoes made for THEIR kind of foot. (or sandals/soft shoes) Morton's foot only becomes an issue when you try to cram a long 2nd metatarsal foot into a shoe designed by and for folks with long 1st metatarsal feet.

(and, of course, they weren't constantly exposed to flat hard surfaces, which I still swear are the bane of ALL modern tootsies)

Morton's foot isn't just a longer 2nd metatarsal, it's also a differently shaped cuboid bone so the foot really does move a little differently. It's also a longer foot, so it's easy to develop hammer-toe because of shoes that are too short in the toe box.

VFF are enough like barefoot that I'd think they'd let your foot do its natural thing, unhampered by shoes designed for a different kind of foot. I'd just suggest you start your VFF running on dirt trails or grassy fields so your foot muscles have a chance to wake up and gain the strength to support your mets properly before you start running on hard flat surfaces.

Knot-doesn't-have-Morton's-foot (but does have dropped 2nd met head)

I agree with you that it's not really the foot that's the problem, it's the shoes and the fact that they just don't fit that foot shape well. Maybe some shoe company needs to design shoes around that foot configuration...or better yet there should be more flat, flexible, soft shoes that don't restrict the foot (and look acceptable for professional settings etc.) since that would be good for everyone, not just those who happen to have Morton's foot. The VFFs should be good, provided they fit you. Not sure what we can do about the hard flat surfaces--they're certainly not the healthiest thing for us but I don't think there's any getting around them.

[OakLeaf]

So is there a stretch I can do to get my first met on the ground? I can't even really do it passively. I quit going barefoot because it was so painful - not the other way around.

[NbyNW]

Anyone else think it's odd that the gadgets they have in shoe stores to measure your feet have sliders to measure, length, width, and length of arch, but it can be very difficult to find a shoe in anything but an "average" width; and I've never seen shoes that are sold with different choices in arch length.

[OakLeaf]

It's no different from anything else that's sold pre-made - shoes, bicycles, clothing. Even the cockpits of automobiles, which aren't offered in different sizes but definitely vary in size. Each make of shoes has a general "philosophy," different models will be variations on that theme, and sizes of each model will keep the same proportions. Measuring your foot gives an experienced fitter an idea of what makes and models to try.

There are still some custom cobblers around, but like custom anything, it's going to cost you.

[ginny]

thanks for the link, Oak. Interesting... yeah, I have blamed my mom for years for putting me in shoes that were too small :D (family joke - you know, blame mom). Since I work in a chemistry lab, open toed shoes are out of the question... bummer, but big, clown type shoes are perfectly acceptable. I will look into that book...

[zia]

I wouldn't think you'd need to pad the 1st met head in a pair of VFFs.

Don't forget, "Morton's Foot" is a perfectly functional foot. Entire civilizations had "Morton's Feet" (Greeks, Celts) and they were vibrant powerful cultures. They weren't hobbling around on crippled feet.

What they had were shoes made for THEIR kind of foot. (or sandals/soft shoes) Morton's foot only becomes an issue when you try to cram a long 2nd metatarsal foot into a shoe designed by and for folks with long 1st metatarsal feet.

(and, of course, they weren't constantly exposed to flat hard surfaces, which I still swear are the bane of ALL modern tootsies)

One of my readings -- which I of course can't find now -- indicated that the prevalence of Morton's Foot had increased dramatically over the past several hundred years. It used to just be 5% of the population, but now it's 25%. In another time, I would have been the one left at the hearth, sewing... or starving.

I'm with you, OakLeaf. Running barefoot is painful. I feel like I am on the brink of a catastrophic injury when barefoot. I love the idea, but I'm not sold on it for my particular foot type. Yet. (Even though I want to be!)

[Bike Chick]

Well this post has been an epiphany! I was diagnosed with a stress fracture a couple weeks ago and the dr described the foot condition to me without calling it Morton's foot. After reading all the posts and checking out the links, this describes my problem to a tee. I bought some moleskin and placed 4 layers under my first metatarcel bone and OH MY GOODNESS what a difference it made! I can walk without pain for the first time in weeks. Forget about walking barefoot anywhere or anyplace because I hobble like an old woman. I still have a copy of my xrays and when I took a look, my second metatarcel bone is a good inch longer than my first.

I have suffered so on the bike with a hot foot on my right foot. I've changed pedals, bought 3 different pair of shoes, then it just got worse when I started running again resulting in a stress fracture. I'm realizing now maybe there's some hope.

Zia and Oakleaf, do you ride with clipless pedals and has it been much of a problem on the bike?

[OakLeaf]

an INCH??? :eek::eek: wow.

I don't actually have any trouble on the bike. I've used Look-style pedals, and toe clips before that. Before I learned about all this stuff, I put the intermediate Specialized arch supports in my shoes, just because they were available and I had custom orthotics in all my athletic shoes; but in my first incarnation as a cyclist, I didn't have any arch trouble or arch-related knee trouble. It's likely I still put more weight on the second met head on the bike, but it doesn't seem to cause the kinds of trouble it does for me on the ground. But the difference in length in my metatarsals isn't near what yours is.

Knot, I really want to make barefooting work. I know it won't happen overnight, but I've struggled for almost a year now in Yoga. In all the standing poses, they're talking about "four corners of the feet" and "creating the arch with your big toe mound" and meantime, I can have my ankles in neutral, or I can have my big toe mound on the mat, but not both at the same time, no matter how hard I try. I can't even take my hands and force it down to the ground without my ankle caving, it just doesn't reach. So that's why I asked about stretches.

[Bike Chick]

Well, Oak, your reaction made me go measure the xray........don't have me guess your height or weight because I apparently suck at guesstimates:D. It was actually between 1/2 and 3/4 of an inch.

Do the custom orthontics help? I'm getting some next week.

[OakLeaf]

Do the custom orthotics help? I'm getting some next week.

As I said in the other thread (or maybe at the top of this one :cool:), they relieved the arch pain and some of the knee pain, but caused all manner of other issues.

I'm transitioning gradually to padding the first metatarsal heads. In the meantime I'm still using the orthotics intermittently. I can't wait to be rid of them! If I didn't have this half-marathon coming up before I've made the full transition, I wouldn't even be using the orthotics at all. I just don't think it's a good idea to do a long race in the pads before my muscles and tendons have had a chance to adjust completely.

If I can then transition to unsupported barefoot, I would really love to do that.

[Bike Chick]

Thanks for the help and good luck on your half!

[zia]

Zia and Oakleaf, do you ride with clipless pedals and has it been much of a problem on the bike?

I do ride with clipless pedals. I have always struggled with the strange sensation that I'm not transmitting enough power through my feet, and that my cleats were in different positions on each of my shoes. (My MF is significantly more pronounced on the left, where my third metatarsal is also longer than the first.) I've actually taken my shoes off to make sure the cleats were in the same spot!

When I was recently professionally fitted, the fitter had me mark on my shoes where the ball of my foot (aka first metatarsal) was and placed the cleats directly beneath that. They actually had been further forward, and moving them back has felt very strange, and not in a good way -- again, I just feel like I'm not transmitting much power through my feet, if that makes sense. Of course this is so -- all my energy is going through my second metatarsal, not my first! Sooo... I'm going to try padding up my bike shoes (perhaps a little thicker than my running shoes) and see if it makes a difference. Maybe it will make me more balanced. And faster. ;)

OakLeaf, you sound like me at yoga. I am constantly wobbling and crashing. I'd always thought I was just uncoordinated... now, maybe not!

[zia]

. Do the custom orthontics help? I'm getting some next week.

I developed a stress fracture in my second metatarsal in ~1992. I am now on my third pair of custom orthotics since that time. As I mentioned before, not! one! podiatrist/sports medicine doc/physical therapist ever paid any attention to my feet beyond the arch/ankle area. NONE of those orthotics had any type of forefoot padding. And I have experienced knee pain on pretty much every single run since 1990 (I am good at ignoring it, and it never lasts long) -- until I self-diagnosed Morton's Foot last weekend and added my own little pads. No knee pain!

My arches are horribly flat, and I think the orthotics were good for them at a certain time and place, especially when my knees were at their worst. My mentor has a pair of customs and she successfully off of them (after 10+ years) about a year ago and I would like to do the same!

Now off to go hook my bike up to the trainer and play around with padding in my bike shoes. :D

[Bike Chick]

I hear you Zia about wobbling and bobbling! The website's description of Morton's foot says it's like walking on an ice skate. I resemble that remark:D

[Bike Chick]

Good luck with the padding. Let us know if it helps on the trainer.

Ladies, this is good info to take to the dr next week. I'm going armed with information and questions. Thanks for your help.

[zia]

Took a spin to nowhere with enhanced shoes on the trainer.

Definitely noticed enhanced contact with pedal. Felt like my cleats were equally positioned. Whether that translates into anything meaningful remains to be seen. It's so hard to tell on the trainer...

[KnottedYet]

Let me reiterate: Morton's foot is NOT a "deformity."
(Knot tears hair out and goes to weep alone in the corner)

The pattern of pains and calluses described on various websites are not unique to Morton's foot. Every foot that pronates too much or that has sloppy muscles and a dropped 2nd met head is gonna be just like that. Greek Foot or Egyptian Foot, they will look and feel the same. Pronation and dropped met heads are POSTURAL problems, not STRUCTURAL problems. They happen to us all.

Now, I'm gonna lecture about accommodation vs correction.

Accommodation is allowing a problem to continue, but finding a way to cover for it. It's like if your brother is an alcoholic and keeps getting into trouble for weaving his way home from the bar singing loudly and cussing at the neighbors. So you start stocking your house with lots of booze so he does his drinking at home. No more singing and cussing, no more problem... right?

Correction is fixing the ultimate cause of the problem. You send your brother to AA. No more singing and cussing, no more problem... right?

The result is the same. The question is which fits into your lifestyle better?

The pad under the first met head is an accommodation.
Stretching the tightened structures of the forefoot and strengthening the muscles of the foot (and really all the way up to the hip) is a correction.

Both have their good points and their bad points.

[KnottedYet]

One of my readings -- which I of course can't find now -- indicated that the prevalence of Morton's Foot had increased dramatically over the past several hundred years. It used to just be 5% of the population, but now it's 25%.

I have a big issue with their statistics and sample populations. (never mind the impossibility of that kind of dramatic genetic change in so few generations!!!!)

If you look at the British Isles, the incidence of Morton's Foot has decreased dramatically over history; as the Celts were overwhelmed by the Anglo-Saxons. (from 100% to whatever it is today)

Morton's Foot is like blonde hair. The incidence of blonde hair has dramatically increased in the Americas in the past several hundred years. And not because people were spontaneously mutating!

[KnottedYet]

(Oakleaf, this is what you were asking for to bring the 1st met head into contact with the ground)

Dropped Met Head Program
To be done over the course of 6 weeks, and maintained there-after.

Consists of two parts: first stretching, then strengthening. Done in that order for every session.

Stretch by folding your foot like a taco shell. Hold your bare foot in both hands. One hand on the left, one hand on the right. Thumbs parallel on top. Line up your fingertips between the 1st and 2nd met heads or on the 2nd met head, whichever feels better. Press down with the heels of your thumbs while you press up with your fingertips. You are essentially folding your foot in half lengthwise. (restoring your metatarsal arch and then some) Hold for 5 seconds. Do 10 times in a row.

Strengthen by working the muscles of the forefoot that support your metatarsal arch. Make a fist with your toes as tight as you can. Hold it for 5 seconds. Splay your toes out as wide as you can. Hold it for 5 seconds. Do 10 times in a row.

Week 1: do the session 3 times a day, spread through-out the day. (morning, noon, and evening for example)

Weeks 2-6: do the session 6 times a day, spread throughout the day. (every 2 or 3 hours, for example)

Maintain by doing however many sessions you feel you need to keep your met arch lively.

Give your feet a happy environment by wearing shoes that suit your particular flavor of foot, and insoles that support your arches INCLUDING the metatarsal arch (buy self stick met arch supports if you have to).

If you also pronate, ask a PT or trainer to help you with your pronation. Pronation has so many causes and so many things to fiddle with up and down the kinetic chain that it is pretty hard to deal with on a message board. They might also want to post your insoles, which is fine, but keep the met arch supports and keep working on your foot strength. As your foot gets stronger and your leg control gets better you'll need less and less correction, and your PT or trainer will trim the posting down until you are neutral.

[KnottedYet]

BTW - Zia, you got some funky feet! 3rd longer than 1st! Ok, now we're talking structural funny business! (not a posture problem, eh?)

[OakLeaf]

Sweet. Thanks (((((Knot))))) you're the best! :D

[Bike Chick]

Thanks Knot:)

[OakLeaf]

The incidence of blonde hair has dramatically increased in the Americas in the past several hundred years. And not because people were spontaneously mutating!

Well I don't know about that... every time I visit southern California it seems like everyone else, regardless of race or sex, has spontaneously mutated into blondes. I'm afraid to stay too long in case it happens to me. It could be spreading to the rest of the country. :p

[zia]

BTW - Zia, you got some funky feet! 3rd longer than 1st! Ok, now we're talking structural funny business! (not a posture problem, eh?)

Oh, don't make me post pictures. I look like I'm missing a toe. They're pretty ugly to look at... :rolleyes:

I'm just amazed we've managed to fill three pages of discussion about FOOT BONES!

[OakLeaf]

I'm just amazed we've managed to fill three pages of discussion about FOOT BONES!

Hon, there have to be at least 20 pages on this board about @ss bones. :p

[snapdragen]

Hon, there have to be at least 20 pages on this board about @ss bones. :p

Not to mention the beloved Diva cup......:rolleyes:

[NbyNW]

Knot, thanks for posting those exercises! My met arch disappeared when I was 26 so I'm guessing my problems are not as structural as I have been led to believe. I'm going to give that program a try.

[OakLeaf]

Well I don't have an X-ray to know how long the bones actually are, but just from looking at my feet, my 3rd met heads are farther from my ankles than the 1st, too. Actually on the left, 2, 3 and 4 are pretty much the same length, 1 and 5 are about equal. Right side's a little bit better.

But stretching and strengthening will still help, right? Between that and digging on my calves trying to work out these trigger points, I'm going to be half chimpanzee before it's over...

Wish I knew a good PT around here. There's a trainer I might talk to when I get down south.

[NbyNW]

It's interesting what an x-ray can tell you -- looking at my feet, it looks like my joints are aligned in a fairly gentle arc, but when I had my feet x-rayed some years ago, the most striking thing was that my first metatarsal was much shorter than I would have guessed.

[zia]

OakLeaf, I just got back from trigger point therapy. The therapist recommended using medical-grade felt as padding. I guess it's denser than foam and lasts longer. This web site http://eGeneralMedical.com has some in 1/16, 1/8, and 1/4 inch thickness, though you have to buy LOTS of it, so not cheap -- around $35. She gave me some to experiment with in my shoes...

Good luck!

[nscrbug]

OakLeaf, I just got back from trigger point therapy. The therapist recommended using medical-grade felt as padding. I guess it's denser than foam and lasts longer. This web site http://eGeneralMedical.com has some in 1/16, 1/8, and 1/4 inch thickness, though you have to buy LOTS of it, so not cheap -- around $35. She gave me some to experiment with in my shoes...

Good luck!

Zia -

The met pads that I've been using are made of felt (don't know if it's medical grade, though). You might want to give these a try as a cheaper option to buying a boatload of medical grade felt padding.

http://www.hapad.com/hapadonline/product.php?productid=16155&cat=278&page=1

[zia]

Ah, interesting, except I want something for just under my first metatarsal, though I suppose I could trim those down... Thank you!

[OakLeaf]

Neoprene's pretty darn dense, though not as dense as felt. I figure it has roughly the same amount of give as my shoes' outsoles, though more than my orthotics. Might be hard to find an old mouse pad thinner than 3-4 mm though.

[zia]

Might be hard to find an old mouse pad thinner than 3-4 mm though.

Giving my old, stinky, too-small, kayaking wetsuit a second look...

[NbyNW]

Oakleaf -- thought you and others watching this thread might find this article interesting:

http://well.blogs.nytimes.com/2009/10/21/phys-ed-is-running-barefoot-better-for-you/

[OakLeaf]

So how are the exercises going, ladies?

My experiences so far:

(1) Oddly, it's the skin over the top of my foot that needs to stretch. The internal structures don't seem to lack flexibility, but the skin sure pulls when I stretch.

(2) My feet are weaker than I thought. :o I'm pretty good at picking stuff up with my toes - and I know wearing Crocs has strengthened my feet quite a bit - but I definitely get some fatigue with the exercises.

(3) The biggest impediment to doing the exercises is taking my socks off in late October - especially with my history of frostbite. Brrrrrrrr. Where are my wool Injinjis???

[jasmine]

I am so psyched to find these pages of discussion about metatarsal pain---I have morton's foot, hammer toe, and big ole bunions--SO I'm trying to get the whole padding idea down, i've read through all of these pages @ 3 times, ordered the pads--2 kind, one from Pro Tec and the the HAdpad ones---thanks everyone for all the amazing info. I still can't figure out where exactly to put the padding--and I can't figure out how to figure it out?? What exactly am I going for ( ob-vee pain reduction!!) in terms of sensation? My first met head is way out of whack so padding under that? My biggest pain issue is on my bike and I've moved around my Look cleats all over but haven't figured out what is best ( yet:D) Though it's tempting to get rid of the clipless pedals I can't imagine not being clipped in and being able to get any real power? I hope this thread keeps going, the more input the better!!!

[NbyNW]

So far, so good. What I notice is that when spread my toes, I feel like I have more control in my right foot than my left.

I feel like it's getting incrementally easier to transfer my weight to my first met rather than my second met when I'm walking on carpet.

This has me wondering about foot exercises that I could be doing for my flat feet, and oh heck, it probably wouldn't hurt to be doing some ankle exercises too. I've been putting off buying/making a balance board for that very purpose.

Incidentally, I've been shopping for a new Pilates studio and one of the places I've checked out also incorporates some Yamuna body rolling into their classes. They've got these bumpy half-spheres called "wakers" that you stand on, on different parts of your foot. They're great for developing awareness of how you distribute your weight around your foot, and for a general massage of the bottoms of your feet! I'm thinking I might investigate this a little more.

Jasmine, welcome to the discussion. I haven't messed with any of my padding yet. One thing at a time for me.

ETA: Oakleaf, I think for the first time I'm considering buying a pair of Injinjis!

[jasmine]

Thanks for the welcome, I have a set of those little Yamuna foot bumpy things, actually I have one, my puppy chewed the other, they are cool and/but painful to get used to. Great for working out soreness and knots but hard to use when pain is acute.

[OakLeaf]

Hi Jasmine...

Listen, Knot knows what she's talking about. The rest of us are just muddling our way through, trying self-help solutions because we don't have access to a competent professional.

So if you don't have anything else keeping you from good posture other than your 1st MT being shorter than the second one, I'd recommend taking her advice.

If you have something else structural keeping you from good posture - as Zia does, and I still need to find someone to actually look at my feet - then pad away and/or try to find a professional who can help you. If not, then I'd really urge you to take Knot's advice.

[jasmine]

yah thanks Oakleaf and thanks Knot I am determined to do all of Knot's foot exercises and recommendations re padding---i have gone to so many "professionals" who look at my feet and gasp and push surgery---so far this thread is the most helpful thing I have come across ever:)

[zia]

I still can't figure out where exactly to put the padding--and I can't figure out how to figure it out?? What exactly am I going for ( ob-vee pain reduction!!) in terms of sensation? My first met head is way out of whack so padding under that?

Follow this link: http://www.triggerpointbook.com/mortons.htm and look at Figure 3. I bought new insoles today, and have it perfect on one foot, still tweaking the other. The perfect foot leaves me with a slight sensation of padding directly beneath the first metatarsal, with the weight of that area being transferred directly onto the pad. My "off" one feels too far to the side, like my foot is sliding off, a little.

Remember the pads should go under the insoles. I'm also experimenting with thickness. I'm at 1/8" right now. That feels about right. Another knee pain free five miles today -- absolutely a miracle, considering I literally had to crawl up the stairs after running a 10K this summer!

Good luck, and report back!

[NbyNW]

i have gone to so many "professionals" who look at my feet and gasp and push surgery

That's been my experience, too -- I've basically been told (by podiatrists) that custom orthotics can be used to correct some of my mechanics and to slow down the development of my bunions, but I will probably need surgery someday.

I had asked about exercises for my arches was told that other than orthotics, there wasn't anything else to be done. Don't get me wrong, the orthotics have been great, but it seems that maybe exercise and stretching has not been part of the training of the podiatrists that I've gone to in the past.

Maybe in the future I need to consult a doctor or other professional with a different set of training/broader range of skills in this area. I'm not at that point right now, but I think it goes to show that it's important to really research the professionals that you consult, which can be tough if you don't even really know what you're looking for.

[jasmine]

Hey I just got a pair of Keen wool clogs--maybe they are called Hybrid's not sure--anyway they are far and above the most comfortable shoes I've worn for my poor achin feet in a long time! It's such a big deal for me to find shoes that feel good I thought I'd share:D

[NbyNW]

ooo, cool! I've had good luck with Keens, but I didn't know they made wool clogs! Time to start writing out my Christmas wish list . . . :)

[zia]

So I have an interesting post-script to this thread. During the course of this thread, my knee pain was nearly 100% eliminated by placing a small pad under my first metatarsal.

Well.

I have been upping my mileage to train for a half marathon, and was very worried after a 9-mile run. My right knee was in intense pain from 5 miles on, and I was concerned 13.1 just wasn't going to be possible.

Nonetheless, I scheduled a 12-miler with my running partner and crossed my fingers for the best. Right before the run, I decided to check the pads I'd put under my insoles, and -- lo and behold -- the right one was missing! I'd been fiddling with the shoes and forgotten that side. I put a new pad on, ran 12 -- at a brisk pace! -- and had no kneed pain at all, and felt great the next day! (Last August, pre-padding, my knees hurt so much I literally had to crawl up stairs after my first Olympic Tri.)

Maybe it was just my body adjusting, but, given my 20 years of fairly persistent knee pain, my bet's on the Morton's Foot diagnosis and subsequent insole changes.

Just thought I'd share.

[OakLeaf]

... I'll update too in case anyone's missed my posts from the general running thread...

I'm experimenting with barefoot running, just a weetie little bit so far. Between Knott's exercises, the hip exercises my own PT has me doing, yoga, and the muscle strengthening I got from putting the pads in my walking-around shoes... I started to feel like I was ready to try it. So far, so good, but just a little so far. With the marathon looming, barefooting isn't my #1 focus right now, but I'll continue to build.

Still, it's pretty apparent that all the cr*p people have been putting in my shoes since I was six years old has only exacerbated my problems. It's impossible to tell at 44 years' remove, but I wouldn't be surprised if it was starting to wear shoes that caused my problems to begin with. It's going to take a lot of work to undo 44 years of imbalances, but little by little.

[NbyNW]

Zia, that's so great that you've had such positive results with that little pad!

Oakleaf, hope the marathon training continues to go well.

I've been struggling a bit. I was pretty religious about doing Knott's exercises for about a month, and then we got really busy moving out of temp housing and settling in to our new place. I usually do the exercises 3-4x a day, but rarely 6. Definitely have increased flexibility in my met arches, especially on the right (not surprising, I'm right-footed, so that foot seems to work a little better).

Other things I'm doing: I work on the trigger points in my shins and calves when I'm watching TV or reading in bed. I've also added in that exercise where you scrunch up a towel using your toes and then push it away, just the toes. I try to do that a couple of times a day. I'm looking to find a balance board/wobble board so that I can add some ankle strengthening/proprioception work.

The barefoot running thing is intriguing but I thought I'd try barefoot walking first, so I've ditched the Birkenstocks I usually wear inside and try to be conscious of my foot posture as I move around the house. I've reduced my use of Rx orthotics and so far no problems. I've been keeping my feet warm this winter wearing Ugg clogs or snowboots, and my orthotics don't fit into either, so it's been great to have that option!

[KnottedYet]

OMG you guys! What perfect timing to bring this thread back up!

I consulted on a patient today who had a classic Morton's foot, with a profoundly dropped 2nd met head and the associated ills.

She had the intense orthotics and the intense shoes... but her over-all leg posture was excellent, especially barefoot.

She wasn't my patient, so I couldn't tell her "do the exact opposite of what you've been doing, and change it soon!" but I gave her a couple websites and strongly suggested she take a look at them.

I used to work closely with a podiatrist who was very anti-surgery. He inspired me and he taught me so much. Working with his patients was a joy, because he let me get creative with treatments and was always willing to teach me, to the point of letting me accompany patients to their appointments with him.

Feet are amazing and beautiful things, and given their 'druthers, they will work! Don't be afraid to try stuff. You'll know pretty quickly if it is going to help you or hinder you.

[Bike Chick]

Glad this thread popped back up too Knot. I had thought to revive it myself because I had something to add.

I had been seeing a podiatrist since September for what he finally diagnosed as Morton's Foot. First he diagnosed a stress fracture (which I'm not sure now that I had), told me to stop running for 6 weeks and sold me a very expensive pair of orthontics. Then he told me he had never heard of Morton's Foot or Morton's Toe and told me I was confusing it with Morton's Neuroma, then a month later tells me I had Morton's Toe, gives me a cortisone shot, talks to me about surgery and tells me to stop running again. That was January and my last visit to him. I went to see a chiropractor instead who is amazing. The adjustments, therapy and pressure point massage have fixed the problem--without drugs or surgery! I'm training for a half marathon and up to running 5 miles and the foot is doing fine (it's everything else that hurts --Ha! Ha!)

Oh, and by the way, the chiropractor told me what my problem was the minute he saw my foot and then looked at the x-ray. He also gave me the same exercises to do that Knot had suggested. The podiatrist told me to never, ever walk barefoot and not to even put shoes on that didn't have the orthontics in them. Gee whiz!

[OakLeaf]

The other thing I've been doing, self-prescribed, is working to strengthen the muscles in the anterior lower leg. As my calves loosen up, it's become clear that my calves were doing all the work holding me upright in a slight forward lean, and that the dorsiflexor muscles are extremely weak. Right now I can work the muscles to fatigue without resistance, just sitting at the computer like right now. ;)

[Morticia]

Hello!

I just signed up to this forum just to post in this thread. I am hoping any of the people who started to wear some sort of correction are still subscribed to this thread . If so, please, please respond!

Anyone else with Morton's foot who is wearing or who has tried correction, I would really appreciate hearing from you too.

Did the correction work long term?
Did you continue biking/running long term?

or anything else.

For me, I did a couple of "double centuries" from Ottawa to Kingston return about 20 years ago and never had a problem. I now do a spin class about once a week and no problem.

But I took up Ballet & Modern dance a couple of years ago and have discovered I have Morton's feet and have a big problem now!. Ballet & Modern dance would be considered like barefoot running because we are basically in bare feet. Except with ballet, the slippers have a pleat gathering on the bottom of the slipper which is about 1/8 inch thick so it is like dancing on a couple of quarters stacked right under the second metatartsal joint. Ouch! It doesn't hurt non-Mortoners because they don't step on the pleat but for people like me it's like stepping on a stone.

Now even walking barefoot hurts a bit- but I am hoping it is just temporarily swollen.

So I am very interested in any longer (or shorter) term stories. I have researched it all but have not come across and long term feedback. Do people have success with the corrections and then just stop talking about it or do they give up ?

I have been to 5 experts so far. 2 say orthotics and don't waste time on exercises. 2 say exercises & training the big toe and possibly orthotics.

thanx & I look forward to hearing from you!

[OakLeaf]

I've been taking Knott's advice and so far it's working out great.

Foot exercises (also hip exercises) - yoga, plus some isolation exercises.

Ditched the custom orthotics (and all other medial arch support).

Metatarsal domes in my running shoes for the time being, but not in my other shoes. I foresee the day when I won't need those - I can walk and stand for hours in flat shoes now - but I can't run without them, yet. (Actually it's been months since I tried, but I'm not changing anything until after my second marathon, October 17.)

Shoes long enough for my toes (and also wide enough for my forefeet, but that's not necessarily related).

General postural work to correct the forward lean that resulted from the unstable base. (yoga again, especially the backbends, and just really being aware of my posture as often as I can).

None of this is an overnight miracle, but I expected it to take some time and work. Learning that my body can heal itself if I learn to stop hurting it ... priceless. :)

[Morticia]

Thanx Oakleaf! I was hoping you were still around :)

I am also wearing metatarsal pads.

I really hesitate to build up the area under my big toe & big toe joint as the whole Morton's foot theory suggests. I don't know why those Morton's inserts aren't mainstream- why just sold on an internet site?. And theories are just that- theories.

Which is why I am hoping to hear from someone who has worn them long term.

Have you been successful in training yourself to step down and toe off on your big toe?

Is your first toe knuckle closer to your body than the second toe knuckle? You can see by putting your foot over a tennis ball to make the knuckles show.

Good luck with your Marathon!! I did a couple of 10k's in the past- that was enough for me!!

[OakLeaf]

Have you been successful in training yourself to step down and toe off on your big toe?

I'm training myself not to toe off at all. My calves were sooooo over-stressed. I'm getting there....

Flexibility in my feet is/was a huge issue. When I started I couldn't even begin to get the head of my first MT on the ground with my ankles neutral. The stretches Knott recommended are helping, and so is rolling out the trigger points in my feet on a spiky stick or spiky ball. That's one thing I forgot to mention in the last post that has been really, really helpful.


Is your first toe knuckle closer to your body than the second toe knuckle?

Yep, I thought that was the definition of Morton's foot.


Good luck with your Marathon!! Thank you! I'm feeling a little odd about it right now so the encouragement is welcome. :o

[Morticia]

I'm training myself not to toe off at all. My calves were sooooo over-stressed. I'm getting there....


hmmm... there is a slight forward lean in ballet. I'm confused. but thanx for mentioning this. My calves are chronically tight.



Flexibility in my feet is/was a huge issue. When I started I couldn't even begin to get the head of my first MT on the ground with my ankles neutral.


Wow, that`s huge! For me, I have to keep my 1st MT head on the ground when in "demi pointe" (tip toes). That is how this whole thing started for me, I would roll outwards off my first MT onto my second.


The stretches Knott recommended are helping,
...


ok, so just to make sure, this is the recommended:



(Oakleaf, this is what you were asking for to bring the 1st met head into contact with the ground)

Dropped Met Head Program
To be done over the course of 6 weeks, and maintained there-after.

Consists of two parts: first stretching, then strengthening. Done in that order for every session.

Stretch by folding your foot like a taco shell. Hold your bare foot in both hands. One hand on the left, one hand on the right. Thumbs parallel on top. Line up your fingertips between the 1st and 2nd met heads or on the 2nd met head, whichever feels better. Press down with the heels of your thumbs while you press up with your fingertips. You are essentially folding your foot in half lengthwise. (restoring your metatarsal arch and then some) Hold for 5 seconds. Do 10 times in a row.

Strengthen by working the muscles of the forefoot that support your metatarsal arch. Make a fist with your toes as tight as you can. Hold it for 5 seconds. Splay your toes out as wide as you can. Hold it for 5 seconds. Do 10 times in a row.

Week 1: do the session 3 times a day, spread through-out the day. (morning, noon, and evening for example)

Weeks 2-6: do the session 6 times a day, spread throughout the day. (every 2 or 3 hours, for example)

Maintain by doing however many sessions you feel you need to keep your met arch lively.

Give your feet a happy environment by wearing shoes that suit your particular flavor of foot, and insoles that support your arches INCLUDING the metatarsal arch (buy self stick met arch supports if you have to).

If you also pronate, ask a PT or trainer to help you with your pronation. Pronation has so many causes and so many things to fiddle with up and down the kinetic chain that it is pretty hard to deal with on a message board. They might also want to post your insoles, which is fine, but keep the met arch supports and keep working on your foot strength. As your foot gets stronger and your leg control gets better you'll need less and less correction, and your PT or trainer will trim the posting down until you are neutral.

I don`t really feel anything when doing the taco shell stretch.. do you feel anything?




.....and so is rolling out the trigger points in my feet on a spiky stick or spiky ball. That's one thing I forgot to mention in the last post that has been really, really helpful.


just fyi, I had a bit of plantar faciitis in my other foot and used the underside of a car mat (the removeable mat ) laid over a hard block, and OMG it was good! I haven`t been using it for this- didn`t know, so thanx.
One of my PT`s also has me doing a `bowstring stretch`. You sit down, grab foot in hand, bend the big toe and then press in on the flexor hallux longus tendon.





Yep, I thought that was the definition of Morton's foot.


I just wanted to make sure- there is confusion out there- it is possible to have a longer second toe but not have a Morton's foot. So I am hopeful then because you have a real Morton's foot. I do too.



Thank you! I'm feeling a little odd about it right now so the encouragement is welcome. :o

hmmm, why odd, I think it is great :)

[zia]

Did the correction work long term?

I have custom orthotics, which never addressed my Morton's Foot issue specifically. Exactly a year ago, I put 3 mm padding beneath my first metatarsal in my running and biking shoes. My knee pain has been greatly reduced!

Did you continue biking/running long term?

Oddly, that little bit of padding has made a huge difference. I'm running faster than I ever have before with only occasional knee pain. I have never had much pain cycling, but my feet feel more "even" on the pedals, if that makes sense.

[jasmine]

I have been fooling around with my own padding, toe spacers, massage, foot exercises--and am much better off ( also thanks to reading all these posts, esp knottedYet) than anything podiatrist or orthopedist says --which is essentially surgery!! Wearing toe spacers functionally has really helped move me along, this was suggested to me by structural integrationist wonderful person and it makes sense. So yup, trust your own knowings and don't listen to naysayers! Believe you can get better and you will:)

[OakLeaf]

@Zia, this thread isn't that old. ;)

I ditched the pads under the first MTs within a few months. If anything, they were making my feet weaker and more rigid than the custom orthotics did.

The point of all this is to get your feet both strong and flexible enough that the parts of your feet that are supposed to support you, actually are supporting you - getting your weight equally in your first and fifth met heads and both sides of your heels, with your ankles in neutral. That takes foot and hip strength, as well as foot flexibility.

I read something a while back, and I can't remember whether it was something Knott said or someone else, but it was along the lines of, "If someone said they can't lift five pounds, would your first suggestion be putting their arms in a cast permanently?" That's what orthotics do - it's like casting your feet - and while a few people obviously do need them, it makes no sense to do that before you've even tried letting your body do what it was born to do.

Now, if a quack ortho put you in orthotics when you were six years old, old biomechanics die hard, weak muscles take time to strengthen, and anything that happens in your feet has consequences all the way up your postural chain. So I'm not "there" yet by any means. I'm still wearing the metatarsal arch supports in my running shoes (they support the second through fourth mets so the middles of my feet don't collapse). I have to mentally give myself posture corrections and tell myself to stop toeing off whenever I do aerobics, stand or walk. Head over shoulders, shoulders over hips, hips over knees, knees over heels. Much of the corrections have to do with correcting a forward lean and a flattened lumbar curve - yoga has been great for this. I can stand for hours barefoot or in flat shoes now, and I'll be tired, but I won't have the back or foot pain I used to get. :) So I can see the day when I'll be able to run without the domes, too.

As far as running, my second marathon is this Sunday. :eek: As far as cycling, I haven't been riding nearly as much this year, only about 2500 miles, but that's not because of any physical issues. I've also been correcting issues on the bike, but not directly related to my feet. Still, it's been instructive, because on the bike, learning to stop ankling, and lowering my saddle to an appropriate height, have had to happen in tandem, little by little. Now my Achilles, my calves and my knees are all happy on the bike. :) It's a good parallel for all the different corrections that are happening in my posture.

[JennK13]

Morton's foot and Morton's neuroma are two different things. Just named after the same doctor.

My husband has Morton's neuroma in his right foot. It seems to have started after he broke his leg 4 years ago in a motorcycle accident. It broke just above the ankle, and they did surgery to put a plate in his leg to hold it together. In the process they pinched a nerve which has since "died" (he has no feeling on the TOP of his foot).
Due to the ankle pain he had while the nerve was dieing, his gait was changed due to limping, and he developed the neuroma. I got sick of his moaning and complaining and told him to go to the doctor or shut up. Our primary care told him he had Gout. I mentioned his pain to my chiro and scheduled an appointment for him. She worked on his foot to "break up" the neuroma. He said he was ready to kick her in the head it hurt so bad and made him cry (he's 6ft, 210lbs)!!! But it felt good after. He goes in every 3-4 weeks and she works that foot to break up the scar tissue, and it's been very successful for him with the pain diminishing with each session. It's been about 4 months now, and he's almost pain free - no shots, no surgery.