“Morton’s neuroma (also known as Morton’s metatarsalgia, Morton’s neuralgia, plantar neuroma and intermetatarsal neuroma) is a benign neuroma (a fibrous tissue formation around nerve tissue) of an intermetatarsal plantar nerve, most commonly of the second and third intermetatarsal spaces (between 2nd-3rd and 3rd-4th metatarsal heads). This problem is characterized by pain and/or numbness,…”
Morton’s Neuroma (n.d.) In Wikipedia. Retrieved Oct 26, 2012, from http://en.wikipedia.org/wiki/Morton’s_neuroma
In cycling what can we do?
One often overlooked aspect of Morton’s neuroma is the tilt of the foot as it relates to the connection with the pedal. When the foot tilts up on the inside (forefoot varus) in a natural position, it has more pressure on the outer rays of the foot during the pedaling cycle. This forefoot tilt is found in approximately 90 percent of the population.
Of course a tight shoe can aggravate a neuroma situation. However, we don’t think we have ever seen Morton’s neuroma on anyone that had a neutral or flat forefoot regardless of how tight the shoe. In every case we have observed, the foot also had tilt at the forefoot.
Hence, wedges are often a helpful solution for many. While this will not always fix the entire problem, we do believe it will help for the vast majority.
Cycling shoes tend to be low volume for most people. Combine this with the typical tilt of the forefoot and the foot will squeeze inside the shoe. Don’t forget to also consider moving the cleat further back on the shoe. Proper fore-aft cleat position is important.
A Wedge helps bring pressure under the first two rays (toes). Or as you can see on the illustration to the right, wedges spread out the pressure. This almost always brings relief from pain and discomfort.
We strongly suggest every cyclist with this issue check the tilt of their feet.
For more precision, seek a BikeFit Pro who can measure the tilt or angle with a Forefoot Measuring Tool (FFMD). Or to learn more about the FFMD click HERE.