What are the four worst traits of a running shoe if you have a Morton’s neuroma? Well, that’s what we’re talking about today on the Doc On The Run Podcast.
One of the most common running injuries you can get is actually a thing called a Morton’s neuroma, and a neuroma is just an irritated nerve. When it first starts, it’s just a little bit irritated, maybe feels a little bit weird. In fact, in one of the original descriptions of the Morton’s neuroma, it was described that you have this sensation of wet leather being stuck to the bottom of the foot, because the nerve’s just getting aggravated and it starts to make sort of little erroneous signals being sent to your brain. But as it progress, it becomes more and more uncomfortable.
You may just get pain when you’re running. You may get numbness, tingling, burning between the toes. There’s a bunch of different things that can happen, but they’re all contributed by irritation of the nerve because you’re either squishing the nerve, or you’re moving it too much in a way that basically causes friction around the nerve.
There are good things about running shoes and bad things about running shoes that could actually help or harm and make the neuroma worse. So, we’re going to talk about those today. The first thing is that if the running shoes are too flexible. For example, if you have a truly minimalist shoe and you have a neuroma, and you’re running in a way, you’re running from such that you actually really have a lot of motion where the toes come up a lot, the heel comes high off the ground, well, all of that motion can actually move the nerve back and forth across the inner metatarsal ligament and irritate the nerve.
In addition, if the way that you run your foot pronates at the end range of motion, it can basically squish the nerve as it moves back and forth between the two metatarsal bones on either side of the nerve. So, when the shoe is too flexible, that’s generally not great.
The second thing is when they’re too narrow. For many, many, many years, there have been lots of descriptions about how cycling shoes and rock climbing shoes, which are both notoriously narrow and tight-fitting, can squish the nerve from the sides by the bones squishing, and squeezing the nerve, and irritated. So, if the shoes are too narrow, that can really irritate the nerve.
The fourth thing is when the shoes are too hard. Now, I actually started to get a neuroma where I was wearing some approach shoes, which were made to wear on the way to a rock climb that were very, very stiff, and they didn’t have much cushion under there. And basically, carrying a heavy load with a lot of gear, and ropes, and all that stuff, it was actually irritating the nerve. And so, if they’re too hard on the surface inside the shoe, that can bug you. Sometimes, a little bit softer insert can make a big difference if you have shoes that you think are just too hard.
The last thing is when the shoes are too flat and what I mean by that is when you look at the shoe from the side, for example, if you look at this shoe. It’s flat here, curves here, and that curves up toward the toes. So, if it’s really flat like this where it doesn’t really bend at all at the ball of foot, that’s bad. Because when you walk, you know that your foot has to move like that. And if it’s really flat, your foot has to move more against the shoe, increasing pressure and friction of the neuroma at the ball of the foot.
So, when you look at the running shoes, if it has more curvature under the forefoot, that’s generally better. When it’s flatter, it also means that by definition, the shoe has to be more flexible, so you want to make sure that it’s not too flat, that it has some curvature, that it has some stiffness. So, when you look at it, you can check the torsional stiffness by rotating it side to side, seeing how flexible it is.
You can bend it and make sure that it really bends easily at the toes and not in the arch. If you bend it and it folds right in half, then the arch is way too flexible. But those are some clues, and those are really the top four things that I see that are the worst traits of running shoes if you have a Morton’s neuroma and you’re trying to continue to run.
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