Why Neuromas & How I Cured Them
When I learned I had Morton's neuromas, my whole athletic life flashed before my eyes. I couldn't run, jump or play sports without the balls of my feet screaming in pain, and the more inflamed they got from trying, the more painful they were to bear.
Neuromas are inflammation of the nerve tissue between your metatarsal bones in the ball of your foot - the base of all athletic positions. Doctors think they're caused by tight-fitting shoes and activities with constant forefoot impact like running, but overall the cause of neuromas is largely misunderstood and there is supposedly no cure.
I first experienced pain in the ball of my L foot in June 2018 while split jerking. My L foot was my back foot and every time it hit the ground it felt like I was stabbing a sharp pebble. Those with neuromas know exactly what I mean, but at the time I didn't yet know I had neuromas so I switched to power jerks and kept training around the discomfort.
Six months later the pain wasn't going away. Some physical therapy sessions hadn't helped so I ended up consulting with 2 podiatrists, got an MRI to diagnose it, met with an athletic trainer and a chiropractor, underwent "conservative treatment" rounds of steroid and alcohol injections, and a radio-frequency ablation procedure.
The athletic trainer prescribed half a dozen foot and toe exercises to work on daily, many which helped me connect my feet to my core but ultimately provided no symptomatic relief to be able to return to athletic activity. The treatments I underwent provided short term relief at best, but my pain lingered and unpredictably worsened in the months following.
The MRI imaging showed I had two neuromas the size of fat blueberries in my left foot in addition to some bursal sac inflammation that needed to calm down. I was advised to stay off the balls of my feet and away from any activity that would further aggravate symptoms. Nevertheless, I eventually felt them develop in my right foot too.
After all the above I'd spent $3,350 for essentially no return on investment which left me feeling hopeless that I would ever alleviate my symptoms and be able to run, jump and play sports again.
Out of desperation I almost considered surgery to excise the neuromas, but the procedure had little promise and would require snipping my transverse metatarsal ligament in order to take out the inflamed nerve tissue, leaving me with a destabilized foot and partially numb toes. Ultimately I decided not to undergo surgery but didn't stop seeking out other opinions on how to resolve the nerve pain.
Up until this point nobody had examined the rest of my body above my feet nor considered how other positional factors might be perpetuating symptoms. Looking back it's astounding that no one thought to seek out the origin of my symptoms or to understand why I developed neuromas in the first place and work backwards to problem solve.
Cheers to the PT who in March 2019 finally told me what I needed to hear to start making a change: "if you have a flat back I KNOW you're on your toes" in reference to my flat thoracic spine between my winged shoulder blades.
Clearly my body (left) had been living on its toes 24/7, lacking the normal convex kyphotic curve in the upper back, and presenting an excessive lordotic curve from the middle back down to my sacrum. With all that backside compression shoving me forwards, it was no surprise that my forefeet took the bullet for a global compensatory strategy that kept from falling on my face.
To achieve the posture on the right took breath work in specific positions, to rotate the rib and pelvis bones through degrees of motion in which they were not doing so, followed by loading the skeleton in those new positions so that they would stick via training. This meant strength training in said positions--positions which were extremely counterintuitive at first but that eventually became second nature with proper coaching.
Decreasing my neuroma symptoms meant addressing how my body was managing and distributing pressure throughout, else experience no meaningful change.
Every day that I would prep for training with positional breath work, my symptoms would immediately diminish if not disappear and I could train planks, lunges, push ups, split squats, etc. By July 2019 I had discovered a predictable pattern of when I'd experience symptoms (when I got out of bed in the mornings, or when I stood up from prolonged periods of sitting) and how to make them go away. As far as I knew this was as good as it was going to get and I was willing to put in the work daily.
Little by little I got back into classic oly lifts (snatch, clean & jerk) and gradually took up sprint training. By the fall of 2019 I was jumping, skipping and running all pain free! If symptoms acted up during training, I'd perform a couple breathing drills between work sets to restore position and then my feet were good to go again.
Fast forward to summer 2020, I discovered the last piece of the puzzle to disappear my symptoms for good: teaching my feet to pronate.
An Achilles strain and tibial stress reaction (quarantined blessings in disguise) forced me to take a big step back from training and figure out why I got injured in the first place. Being a nerdy trainer I sought out the best of the best to help me rehab and reeducate my lower limbs. What I learned about my L foot was that it could not truly pronate, despite appearing to be flatter than my R foot. Both feet in fact lacked degrees of motion in the mid-foot, which are necessary for your arches to spring up and down from the floor during walking, running and jumping.
Upon assessment my L heel would lift off the floor before the arch had a chance to relax down to the floor as I bore weight through it. Instead of my heel staying heavy on the ground, it would come up too soon causing my toes to grip for dear life.
This was a BIG CLUE in appreciating how the inter-metatarsal nerves developed inflammation - the bones surrounding the nerves weren't moving and gliding the way joints are supposed to!
You can see in the video above what is supposed to happen when the foot moves through pronation and back to supination every step we take. The long metatarsal (toe) bones should spread as we load our weight onto the mid-foot, keeping the heel heavy in contact with the floor before going into toe-off in which the foot arch springs back up.
If you've ever worn a metatarsal pad to manage your neuroma symptoms that's essentially the purpose it serves, only it doesn't teach your foot how to actually pronate like a healthy moving foot should. This means that whether you wear the metatarsal pad or not, your foot still won't pronate properly unless you train it to.
As soon my PT walked me through a proper foot pronation, it taught my brain something completely new that it hadn't been doing before. Upon regular exposure to that novelty, it started to stick both during training and outside of it.
The next morning when I got out of bed, my feet didn't feel stiff nor did I have to walk around to desensitize the ball of my foot. When I went to prep for training, I felt no symptoms that warranted my usual breathing exercises to shift my weight back to my heels. Over a year later I'm still feeling symptom free 99.99% of the day and night! And if they ever do show up from time to time I have the tools to make them disappear so I can train like the athlete I am.
I wanted to share my success story if you or someone you know is struggling with neuromas, because I know they're a b*tch. PLEASE share this article and reach out to me - I'd love to help you overcome them so you can free yourself of their debilitating symptoms. It turns out that through movement we can indeed influence symptoms and change how we feel, with the added bonus of potentially avoiding costly "treatment" that didn't work for me and nor most of the other neuroma clients I've since consulted with.
Stay strong, stay healthy