Morton's Neuroma


Experience From - Rodger Smith, Al Zeller, Dave Combs, Scott Rafferty, Tim Jantz#1,DPM, Katie Fernan, Jim O'Neil, Tim Jantz#2,DPM, John Vonhof,

Rodger Smith

Has anyone had surgery for Morton's Neuroma? If so, was it successful, and how soon were you able to run again? I've read that one, after surgery, can stand on the foot that day and run in two weeks.

I haven't been able to run for more than three months. Had pain in the metatarsal and ball of the foot areas for a year and a half and stopped running when I started to limp just walking. I'm taking 800mg of vitamin I for three weeks and there has been an improvement, but not to where I can run.

Any advice/knowledge is much appreciated.

Al Zeller

I have been running about 10 days now since being off after my Morton's neuroma was removed. Yes, you can walk on the foot 2 hrs after surgery. I was off running for about 4 weeks, but it probably would have been possible to run short distances after 3 weeks. I started walking 2-3 miles at 3 weeks, which was more comfortable than running. Since they go in thru the top of the foot, when you start running there is very, very little pain. I wish I would have had it done 3 years ago.

Dave Combs

Yes, I had the surgery (for three different neuromas--first two in May 1990, one on each foot, the last in August of the same year.) Yes, it was successful. In both cases I was off my feet almost entirely for a bit less than a week, then could only walk around for a couple weeks. I managed a VERY short jog (1/2 mile or so) after 3 weeks, and was able to run again for reasonably short distances (3-5 miles) after 4-5 weeks. By 8 weeks everything was pretty much back to normal.

The 'stand on it that day and run in two weeks' is baloney, IMHO. Anybody that can do that is VERY unusual, and I've never heard of a case like that. The sutures from the operation itself take 10 days before they're removed, and I really doubt you'd be allowed to put pressure on them the day of the operation.

"I haven't been able to run for more than three months. Had pain in the metatarsal and ball of the foot areas for a year and a half and stopped running when I started to limp just walking. I'm taking 800mg of vitamin I for three weeks and there has been an improvement, but not to where I can run.
" I wonder if the surgery was done correctly.

Scott Rafferty

My surgery for Morton's Neuroma had a very difficult recovery, involving a week of bedrest and pain, followed by two months without running. The two morals are specific to my situation -- (1) Avoid surgery for any foot condition other than Morton's Neuroma. (2) Do not combine MN surgery with other surgery. A third point - there is no alternative (at least for ultrarunners) to surgery for MN.

My former HMO fought having the surgery, insisting on long wait periods with orthotics and antiinflamatories. These just won't solve the problem for a serious runner. Once the HMO conceded surgery, however, they decided that it would be "economical" to "correct" a hammertoe that had never bothered me.

The joint surgery was extremely painful and extended the recovery at least six weeks. The multiple incissions also required a different tourniquet, which led to permanent weakening of the toe. The toe is now shorter, but is elevated, and does not "purchase" the ground. This results in pain to the surrounding metatarsals. They admitted that the operation was a failure should be "done over" - but that meant more down-time and permanent further weakening of the toe. I changed HMOs.

Be very insistent on prompt surgery for MN -- and very skeptical about any other foot surgery. And don't buy into the argument that you can get it all done at once.

Tim Jantz #1, DPM

I agree with scott's advice on neuroma surgery. when I perform neuroma surgery I try to make that the only procedure. it makes recovery much faster, but it is important to take it easy after the surgery. one of the complications that can occur post op is a hematoma. when removing a neuroma,a dead space is created. if a person is too active after the surgery this space can fill with oozing blood. this can be a focus for possible infection, and/or pain. I recommend to my patients that they stay off there feet for at least a few days post op. I know many people will respond and tell of how they ran 2 days to 7 days later with no problems. but trust me, it is one heck of a lot easier taking it easy for a few weeks to allow the surgical area to heal properly than to tempt fate and risk a lengthy recovery.

I'll get down off my soapbox now.

Katie Fernan

I've had a few requests to keep people posted on how my removal of my neuroma went.

Here it is 15 days after surgery, and I'm almost walking normally. I can finally put all of my weight on my foot while bending it, but I can't bend it all the way yet (go all the way onto my toes). I think this is pretty good progress considering that I just graduated from my surgical booty and got the stitches out (9 of them) on Tuesday.

Some things I've done that I think have helped:

One last thing that I will do (my friend who is a PT gave me this advice) is to rub the area around the incision, perpendicular to the incision. She said rubbing like that after the wound is healed will help reduce any scar tissue.

That's my report.

Jim O'Neil

I've seen several posts in the past few weeks re: Morton's Neuroma. Most have dealt with the recovery periods after surgery (I see mixed results) or whether to have surgery at all. I ran a long trail/road run today, and at times my right foot felt like it was on fire. The discomfort was so severe that at one point I stopped, took my shoe off and massaged the metatarsal area. That helped a lot, but the pain eventually returned. Aside form surgery, what else can be done to alleviate the pain associated with Morton's Neuroma? Orthotics?

Tim Jantz #2, DPM

conservative treatment for morton's neuroma includes the following:

  1. vitamin B6 300 mg a day (in divided doses)

  2. nsaid's (aleve, advil, asa...)

  3. steroid injections with or without ultrasound

  4. orthotics with or without a metatarsal pad (the pad helps lift and seperate the metatarsal heads & phalangeal bases (toes) so the nerve doesn't get pinched.

  5. possible shoe change; is the flex groove too big? is there enough forefoot cushion? is the heel too high causing too much pressure on the ball of the foot? heck even try a 1/4" plain spenco insole for extra cushion.

  6. run on soft terrain, decrease your miles and frequency.

I switched sizes of shoes and flared up my neuroma and it has taken months to get it calmed down. i baby it, ie: shoe change, 1/4" spenco isoles under orthotics. the hardest part was giving myself the steroid shots!

If all else fails and the pain does't get better or can't be controlled then consider surgery, but many times neuromas less than 6 months in duration can be handled conservatively.

John Vonhof , Author: FIXING YOUR FEET: Preventive Maintenance and Treatments for Foot Problems of Runners, Hikers, and Adventure Racers

"Sometimes a correctly placed metatarsal bar or pad can decrease the pressure of neuroma and buy you some time. See your local running podiatrist.
" Call HAPAD at 800-544-2723 and get their catalogue showing all their foot pads and inserts. They have several metatarsal pads and bars that work greta. The material is wool coiled spring-like fibers. They have an adhesive that allows them to stick in the shoe. By removing fibers at pressure points, you custom fit the pad to your foot. I consider them one of the great finds for footcare. (I have no financial interest in the company, they just make a great product and the staff is very friendly and helpful over the phone).