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Image by Meghan Holmes

Training for Morton's Neuroma

 Online coaching + individualized strength training programs designed to cure your neuroma symptoms, no matter how long you've been struggling.

The #SkilledStrong Approach:

  1. We start with a thorough Initial Assessment to determine which areas of compression in your body are shifting your posture over the forefoot 
     

  2. You get started on daily repositioning exercises to begin restoring non-compensatory mechanics throughout your body and improve movement in the feet and ankles
     

  3. Meanwhile I design a customized training program tailored to your assessment findings, specific postural needs and the training equipment you have available to work out with
     

  4. I send you the program and coach you through the exercises you need most help on so that the form you execute works to shift your center of mass backward toward the heel, and off the forefoot
     

  5. You put the work in consistently and within MONTHS you’ll notice significant relief in your symptoms

Understanding Posture

and Morton's Neuroma

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Your posture can aggravate Morton's neuroma symptoms when you're stuck in a forward weight-bearing posture unkowingly.

Notice how most of my body mass rests in front of the plumb line drawn through the heel bone.

A center of mass that is shifted forward of the heels limits the degrees of rotation available in each joint throughout the body, including the 33 joints that comprise the foot and ankle.

Metatarsal bones that cannot rotate cannot splay, and so they will compress on the nerves living between them.

My experience healing Morton's Neuroma

When I found out I had neuromas in 2018, I was determined to find a cure despite not getting relief from “traditional” treatments nor the professionals I had consulted with. I was NOT getting a surgery that could complicate matters down the road, keeping an open mind as a personal trainer that this could in fact be a movement problem. Movement problems need movement solutions, not necessarily medical interventions.

 

After several consultations with various professionals, it clicked that I had to address my posture if I wanted to stop perpetuating inflammation into the forefoot. Exercising in a manner that repositions my center of mass off of my toes and back over the heels would have to be the first step even if it didn’t bring any immediate relief whatsoever; then it would have to be stressed + followed by repetition + frequency for the postural changes to stick.

Why?

Because over the years my skeleton had adapted into a position of extension due to sport and stress, and this limited how freely my bones could roll and glide upon each other, particularly in the feet. It took years for my body to adapt to such compensatory posture as default, so it would take highly dedicated focus in a shorter period of time to bring it back to neutral.

As a trainer who studied Postural Restoration, I had the advantage and skill set of knowing how to manipulate exercises to restore normal joint position throughout my body. I designed myself a strength program that focused on exercises to improve range of motion at the hips and shoulders by influencing the shape of my rib cage and pelvis. Prioritizing the specific positions I needed to train in resulted in a global, long-term effect on all joints throughout my body, trickling down nicely into the feet and ankles.

Shifting my focus away from bilateral lifts and more towards training rotation is ultimately what worked to cure my symptoms within about 3 months. As it turned out, training consistency would make or break my progress. Slowly but surely I was able to walk, run, skip, jump, hop and sprint again all pain-free.

Based on this experience, I can tell you that deciding to change your approach and invest more time (and possibly finances) in a new direction is the hardest decision you will need to make once you realize that what you've been doing is not working.

This decision is harder than electing whether or not you'll get the surgery because it often requires more resources in order for training to work. But when you consider the high risk of complications, stump neuromas, worsening symptoms, foot destabilization etc. that can follow the operation, you come around to appreciating the healing effects of exercise for all its accompanying benefits that follow.

Having optimistically gone through this transformation first hand has enabled me to provide a holistic approach for clients who also decide to pursue a strength training approach after conservative treatments failed to address the root cause of their symptoms.

As of February 2023 I’ve now helped dozens of neuroma clients manage their symptoms via online training and they will tell you it's the best investment they could have made.

WHAT NEUROMA CLIENTS SAY

Before training I’d been struggling with neuroma symptoms for 2 years after an ultrasound confirmed the diagnosis. They would get really bad after walking 100 meters and I couldn’t handle standing on my feet for very long, let alone play sports. I tried wearing a walking boot and did some physical therapy, both which were unsuccessful in eliminating symptoms. If I tried running my feet would get achy after a mile or two. I received an injection but it didn’t help, so I started wearing athletic shoes with more cushion, inserted a pad in my orthotic to offload the area, and wore toe spacers at night. One day my dad came across Romina’s blog and I was willing to try something different since “conventional” routes weren’t working. Within 2-3 months of training I could walk longer distances without symptoms and noticed an overall reduction in aches/pains/new injuries. I got back to playing soccer and volleyball quickly after and I was able to work out in the gym with confidence because I had a plan that I trusted would help me and it felt so good to move again and gain strength again! This has changed my life. I would not have been able to gain function again without Romina’s training and individualized approach. The consistency and variety of workouts keep me engaged, and her wide breadth of knowledge gives me confidence because she understands anatomy and physiology in ways to create lasting change that the Western medicine approach does not. Many doctors and physical therapists today only focus on the symptoms and not the root cause. Breathwork, positioning and foot pressures, how I work out, move, and navigate life have changed dramatically for the better. I would recommend this training in a heartbeat.

Liz, 25

I experienced neuroma symptoms for 3 years before I decided to try training with Romina. Multiple podiatrist visits confirmed I had MN and the pain impacted my ability to do things like hiking and backpacking trips. It even made me hesitant to visit friends without bringing my own slippers, for fear of having to walk and stand shoeless on hard floors. I tried cortisone shots twice and a replacement pair of orthotics with no improvement. Metatarsal pads didn’t help much either. I found Correct Toes worked pretty well but made my toes hurt after several hours. What worked best was separating my toes daily with cotton coil. ​ When I first considered strength training I thought of it as an experiment. It felt worth a try, and plus it was a chance to mix up my strength training workouts. Within 5 months I weaned myself off of cotton toe spacers for daily wear, and within 6 months I found I didn’t need them for backpacking trips either! Strength training has granted me the freedom to be outside in winter without my neuroma-triggered tingling and numbness making me want to run inside, and I can be barefoot without triggering symptoms. It’s also allowed me to hike and backpack as much as I’ve wanted, and provided for some adjustments to my walking technique inspired by the training. I’d say if you’re on the fence about your options for finding a cure, definitely give strength training a try because it’s done wonders for me.

Sheelah, 44

Prior to working with Romina I had been experiencing symptoms off and on for a decade, but in the last year it was ongoing and impacting daily living, volunteer work and outdoor activities. I had tried shots and insoles and changed shoes many times to try to stay active. I initially sought out treatment via physical therapy, then acupuncture, and finally consulted an orthopedic surgeon and 2 podiatrists. I had months of therapies, multiple steroid shots, several custom orthotics, tried self massage and numbing creams so I could ski and hike, and even changed out shoes and boots repeatedly first with orthotics and again with the custom one - all with no improvement in symptoms. ​ It made sense to me to try training as I had already tried to change my gait which was very far forward over my toes. One of my physical therapist friends suggested I look into it since I already did a lot of other training, and standard physical therapy for the foot wasn't helping. I’d also wanted to increase the amount of strength training I was doing to maintain muscle mass and balance as I aged, so even if it didn't help with the neuroma I knew it would be good for me to learn better routines and techniques. ​ After 3-4 weeks of training I noticed I could go up and down the stairs without searing pain, and it was another month or so before I could hike or ski without using numbing cream. These improvements have continued over the past year of working with Romina, not just in the foot but my thoracic and lower back pain have reduced significantly. I no longer use the custom orthotics and have returned to using older shoes I once could not wear comfortably. I can now ski 12 miles, hike with a backpack for days and am better balanced on scree and boulder fields without experiencing symptoms. I’m also learning to use my body differently and have lost some of the joint aches like my former knee pain, although there is more I can improve. I've gained back some muscle mass too which will be important for longevity and health, and my balance and agility have also benefited tremendously from this training process. I have a newfound desire to actually train 2-3 times a week instead of just doing aerobic activities and have regained the ability to move my ribs and torso which I lost in 2004! I am beginning to have a subtle change of attitude about what I can do and try - that is probably the most important of all. I only wish I had started training sooner before the neuroma was such a problem. This is the only "treatment" that will offer you the benefit of using your whole body better as it will give you tools for health and strength. It’s amazing how much Romina can do via online coaching and video. She continues to surprise me when she finds rather subtle movements to improve so there's a lot of benefit to be gained with this training beyond curing neuroma symptoms.

Claudia, 57

FAQs

How long does it take to feel an improvement in my neuroma symptoms?

 

Just like any fitness goal, it generally takes 3-6 months of consistent training to achieve results. By prioritizing rib cage and pelvis position in your exercise form, you will notice a gradual improvement in symptoms within the first month, and a significant difference in your ability to walk, run and play sports within 5-6 months (perhaps even sooner!)

What does the rib cage have to do with neuromas?

In order to redistribute pressures internally and shift your center of mass backward off your forefeet and toward the heels, we must address the rest of the body above your feet. The rib cage is a large, heavy structure that houses important organs like the heart and lungs, as well as the diaphragm. In most everyone I assess we discover that the rib cage is stuck flared forward in space (due to a variety of factors, but easily influenced via respiration). This means the weight of the rib cage, plus the weight of the organs inside and below it are also shifted forward toward the toes, which comprises pelvic position, which ultimately limits mobility down the chain into the feet. If we train to restore dynamic movement in the rib cage, we ultimately change how every bone interacts in the skeleton, redistribute your body weight back over the heels, and therefore regain the ability to move through foot pronation (metatarsal splay) and supination (arch lifts).


In short: Position dictates what muscles can do. If we want a foot that can pronate, we need a hip and rib cage that can absorb weight on that side. If we want a "functional core" we need optimal rib cage + pelvis positioning so the diaphragm can interact with your pelvic floor. Training away neuroma symptoms means stressing different exercise positions that get you out of the patterns perpetuating a forward weight-bearing posture.

What is the success rate of #SkilledStrong strength training to heal Morton's neuroma?

All clients who train at least 3 months or more see an improvement in symptoms, if not completely rid themselves of symptoms all together. This is because they dedicate at least 3-4 hours per week to their customized strength training program, meet with me on a weekly basis to ensure they are getting into the right positions and performing the exercises as needed, and check in with me outside our scheduled zoom calls to stay on track with their progress. Daily repositioning exercises are provided following the Initial Assessment to manage posture as frequently as needed. A custom training program consisting of 2-3 workouts per week is created for you upon signing up for Online Coaching.

How do I know which Online Coaching plan is right for me?

This largely depends on how experienced you are working with a coach, how in touch with your body you are, and how quickly you pick up new skills​.

 

If you're completely new to training, it's likely you need more frequent coaching in order to get results. In this case it's recommended we meet 2-3x/week so that my eyes are on you regularly, helping you get into the right positions and troubleshooting live on our calls as needed. This way you're introduced to fundamentals to keep reinforcing, rather than unknowingly developing bad habits that perpetuate a forward weight-bearing posture.

 

If you're an experienced trainee and can hold yourself accountable to the process, then we can meet once per week to guide positioning and ensure you're nailing the exercise progressions. Training programs will always be progressed based on your feedback and how well you manage core positioning throughout the exercises.

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