Feb 6, 2010 at 12:10 pm #1254925
Recently I developed a Morton's Neuroma, which is a pinched nerve between the metatarsal foot bones in the forefoot. This is most often caused by shoes that aren't wide enough, especially in the forefoot, a sharp rise in the underside of the toe box which bends toes up, and foot bones that may be spaced closer together. Basically shoes that constrict the forefoot bones and force the toes up at a sharp angle are leading causes.
In my case, my normal width size 11 feet flattened and widened a bit after serving in an elite airborne unit many years ago, and slowly flattened/widened a bit with time, and yet I failed to realize I needed to adjust to shoes with a wider forefoot. Nothing super wide, just wide forefoot. So I need to replace my normal (D) size Salomon Solaris trail shoes with ones with a wider forefoot and toe box.
Also need to use an orthotic with a metatarsal pad right behind the metatarsal bones, which helps spread the bones from the nerve. For now I'm using stick-on metatarsal pads with either the standard insole in my shoes or Superfeet Green (regular arch) insoles before making orthotics.
It was bad enough that when I went on the BPL Bay Area 2nd Annual Pt Reyes overnight recently, I had to wear my Keen Growler 200g Thinsulate winter boots, which had the widest forefoot of all my shoes. A bit warm but the eVent breathed well and at least I got to go on the trip.
I'm 6 ft tall 185 lbs and prefer lightweight to medium weight shoes with good torsional rigidity and decent padding. Bare bones padding (pun intended) isn't going to work for me. I'd describe myself as lightweight in style, not ultralightweight.
I know that the new Montrail AT Plus will be available by late Feb/early March – that shoe has a wide forefoot and toe box and is supposed to be like the Montrail Hardrock 08. The shoe is supposed to have good torsional rigidity and padding and looks like a great replacement shoe for me.
Which other brands and shoe models, such as innov8, would you recommend?Feb 6, 2010 at 12:37 pm #1570482
@jdw01776Locale: Southeast Texas
I also like a wider forefoot/toebox. I used to look for New Balances that used an SL-2 last, but they don't make trail-runners using that last anymore. I've since switched to Adidas Supernova Riots, which have a wide toebox…Feb 6, 2010 at 1:51 pm #1570522
Take a look at the La Sportiva Wildcat. The toebox is wide, and very deep. My feet are shaped sort of like duck's feet, and they fit me great.Feb 6, 2010 at 2:00 pm #1570527
@rcaffinLocale: Wollemi & Kosciusko NPs, Europe
> my normal width size 11 feet flattened and widened a bit after serving
I know … both my feet and my wife's feet went up a size when we spent 3 months walking in France. New shoes.
> Which other brands and shoe models would you recommend?
My wife and I have had great joy from New Balance shoes in a 4E fitting, and they have lots of those. Even better, their web outlet at http://www.nbwebexpress.com/ allows you to search the entire range with different selection criteria, including width! Love it. Unlike most other companies which won't even list their shoes widths!
(I have no connection to NB, but I do like their shoes.)
CheersFeb 6, 2010 at 2:03 pm #1570529
@chadnscLocale: Duluth, Minnesota
I too have a wide toebox and I've found that Salomon trailrunners to work very well for me.Feb 6, 2010 at 2:30 pm #1570539
You might add the Vasque Blur to your list to checkout. I also have a wide forefoot and the Blur is about the most comfortable trail shoe I have found. For me at least.Feb 6, 2010 at 3:21 pm #1570565
@davidlutzLocale: Bay Area
I have toebox issues also…the only shoes that work for me are Keens.
They make a whole line of footwear, including what they call trailrunners and lightweight hikers.
Since the Growlers work for you, maybe stick with that brand.
DavidFeb 6, 2010 at 4:11 pm #1570589
@tippymcstaggerLocale: North Texas
You've probably already thought of this, but you can trim the toe off your insole for a little extra volume. Your Superfeet Green has a curved line on the bottom to guide your scissors. Get well.Feb 6, 2010 at 4:38 pm #1570604
@jameslantzLocale: North Georgia
Since you are already familiar with Keens, you might want to try the Shellrock. They have a huge footbox as do all Keens & coupled with New Balance insoles with metatarsal support, might be a good combo for you. The Shellrocks are not waterproof but ventilate well & have a non aggressive tread best suited for dry conditions. Mine have seemed to hold up well. The only limitation is that they are not well suited to snow & will "wet out" in rain, but dry relatively fast.Feb 6, 2010 at 4:58 pm #1570614
@iwillchopyouhotmail-comLocale: Lake Tahoe
Adidas Supernova Riots.Feb 6, 2010 at 7:25 pm #1570658
@scfhomeLocale: Chocorua NH, USA
Since you wear orthotics, thought it might help to know about PAL carbon fiber prescription orthotics that come with a reinforced Spenco footbed attached. They are more flexible than hard orthotics, so work better in hiking footwear. Many podiatrists are familiar with them, and will order them with your prescription. Have used them in Zamberlan light boots, Keen mids, and Danner 452s, and they
have held up real well, while also preventing a return to painful issues with my feet.
SamFeb 7, 2010 at 11:42 am #1570823
@brianleLocale: Pacific NW
I just had surgery for Morton's Neuroma on one foot in late Nov, and needed a wide toe box shoe before I got it due to little-toe side bunions (bunionettes). Hmm, I went to jump school too back in the day (1976 …), but I don't think that's related! :-)
I've been using Golite shoes for the wide toe box, and they made a big difference with the bunionette problem — my options were basically surgery for that or a wider toe box.
I have no idea if the tread pattern on the Golite shoes contributed to me getting Morton's Neuroma on my 2008 PCT thru-hike. It's possible, in that the deep lugs IMO seem to sort of focus the pressure of each footfall onto certain parts of the foot.
But because I otherwise like Golites a lot, I'm using them again on my AT thru-hike attempt starting in 18 days. Hopefully the result won't be Morton's Neuroma surgery on my other foot next year (!). In fact, I'd been looking for something like a thin kevlar or similar below-the-insert piece to sort of help spread the impact of each step more uniformly around the ball of my foot. Seems like I heard about something like that once, but haven't found it. If anyone has a pointer to such a product, I'd appreciate it!Feb 7, 2010 at 2:22 pm #1570881
Thanks for all the very helpful suggestions. A few questions:
Do the Adidas Supernova Riots also have a wide forefoot or are they available in wide?
1) which New Balance shoe models do you use? There are so many. I use their running shoes exclusively because of the wide sizes, durability and motion control. I have the 1221 for running.
2) Do you use the 4E because that’s the size of your feet, or because you want to allow for a lot of foot expansion? What size are your feet now? Want to get a sense of whether or not I should just get wide rather than very wide NB.
which Salomon trail running model, does it have a wide forefoot and toe box and does it come in wide sizes?
Do you buy the Vasque Blur in a wide size or the regular size has a wide forefoot and toe box?
My wife and I love our Keen Growlers. Which non-waterproof Keen hiking/trail shoes do you recommend?
Which New Balance insoles with metatarsal support are you referring too? By metatarsal support do you mean padding, or an oval metatarsal pad in center of the insole right behind the metatarsal bones to spread the bones? I absolutely need the pad.
I’m looking into PAL carbon fiber prescription orthotics – hadn’t heard of them yet but given my first podiatrist that is no shocker – left in her hands much longer and I won’t be able to walk. She's a nice person but didn’t even check my shoes when I saw her and just gave me metatarsal pads to put in them (even though the pads would make my too narrow shoes constrict my foot bones and pinch the nerves even more). I even asked her if I should buy wider footwear and she said just try the pads first. Sign of a terrible practitioner. Fortunately my friends know a great pedorthist back East and friends in Silicon Valley referred me to a podiatrist who is a long distance runner that a lot of runners swear by.Feb 7, 2010 at 2:23 pm #1570883
List so far:
Montrail AT Plus – wide forefoot and toe box
Adidas Supernova Riots – only available in D but has a wide and deep toe box
La Sportiva Wildcat – roomy toe box, but not available in wide
Salomon trail running – model?
Keen – other models?
Golite – which models?
innov-8 – which models? Do they have enough cushioning?
Salomon XA Pro 3D Ultra Wide – very roomy, breathable, quick drying, entirely synthetic, responsive
Mizuno Wave Harriers – wide forefoot, roomy toebox, aggresive sole, very light, but the padding is minimal, so maybe check out other Mizuno models.Feb 7, 2010 at 2:35 pm #1570886
Brian, I really hope to avoid surgery. I’ve heard of 1-3 months recovery on crutches in a foot brace. How long were you off your feet? If I have to I have to but it would drive me crazy.
The other concern is that in the surgery they don’t just remove the nerve but cut the tendon that runs across the metatarsal bones to spread the bones and prevent a recurrence, and I’ve read this can result in some loss of forefoot control. Have you experienced this?
From what I’ve read the number one contributor to a neuroma is narrow footwear and the sole rising too aggressively under the toe boxes pushing the toes up too much, second is your metatarsal bones being spaced closer together. It’s certainly possible your lug pattern contributed – a good pedorthist or podiatrist who makes orthotics could help you pinpoint.
You should definitely see one to help you make a good long term orthotic for both feet, even if you had the surgery already. You see even with a wider toe box you need to make sure your insole and shoe are spreading the forces of each step, minimizing injury to any one area.
Search the Superfeet website for the Morton’s Neuroma article, and you might find this article on orthotics helpful: http://www.podiatrytoday.com/article/1891
Also a related recent thread I think you commented on: http://www.backpackinglight.com/cgi-bin/backpackinglight/forums/thread_display.html?forum_thread_id=27372
Which Golite model do you use?
Jump school is quite an experience. Had a blast with my buddies. However, regular circular military chutes drop you like a lead rock. Civilian jumpers don’t realize what an impact it is.Feb 7, 2010 at 2:40 pm #1570890
I am not aware that the Blurs come in a wide. In any event I bought the regular. I did buy them 1/2 size larger than my normal size and that may have some influence on the comfortable fit. But even with the larger size they do not at all feel loose. Just very comfortable with lots of toe room. The lacing system seems to hold the foot snugly in the heel socket and no problem with excess forward slippage on downhill terrain.Feb 7, 2010 at 2:45 pm #1570891
@mikefaedundeeLocale: Under a bush in Scotland
I too need a wide forefoot, and am currently using Mizuno Wave Harriers. They have a wide forefoot and roomy toebox, and an excellent aggresive sole. They are very light, and the padding is minimal though, so maybe not what you are looking for. Maybe other Mizuno models may suit, if these are too minimal.Feb 8, 2010 at 8:52 am #1571107
@thinairLocale: 6237' - Manitou Springs
I too have Morton's neuromas, in my case on both feet.
Some suggestions that have not been mentioned in this thread, but I have mentioned them before:
– Alternatives to surgery are Cryosurgery, or Sclerosing Injections which worked pretty well for me personally. Here is a link to get you started on research http://www.podiatrytoday.com/article/2691
– I had some success with accupuncture but it is very expensive and not covered by my insurance
– You can do a lot with lacing, don't overlook this. I lace my boots so the forefoot is loose and the arch is snug to keep the foot well back in the boot.
TimFeb 8, 2010 at 8:59 am #1571111
@adamallstarLocale: Central Texas
Off trail, I had the best results with a neuroma wearing Chaco sandals. The supportive footbed and wide front foot area made a huge difference.
A pair of my everyday shoes agitated my foot the most and after I replaced those my foot problem hasn't been as bad.
My podiatrists suggested orthorics, but recommended using some superfeet inserts since she said she saw mixed results with orthotics.
Good luck!Feb 8, 2010 at 9:35 am #1571132
Give these a shot: Salomon XA Pro 3D Ultra Wide-
You currently wear Salomon's so you may have good success with them. They're still my favorite trail runners. I've been wearing them for about 3 years now. I used to wear the regular width, which seemed to stretch after a few days' use but have since moved to the wide sizing and they're very roomy. They also fit the bill for most things we look for in footwear here at BPL- breathable, quick drying, entirely synthetic, responsive.Feb 8, 2010 at 10:21 am #1571149
@page0018Locale: Southeastern USA
Hitchcock Wide Shoes for Men at http://www.wideshoes.com has a wide selection.Feb 8, 2010 at 11:10 am #1571170
@brianleLocale: Pacific NW
"Brian, I really hope to avoid surgery. I’ve heard of 1-3 months recovery on crutches in a foot brace. How long were you off your feet? If I have to I have to but it would drive me crazy."
First off I should say that I did first try a series of alcohol injections, and I think by the third one they *might* have helped some; kind of subjective. After the surgery, pathology confirmed that the nerve was flat "damaged" and wasn't ever going to heal.
I had the surgery in late November, and was pretty much completely immobile for ~3 weeks, mostly immobile for the next 3. After 6 weeks I started ramping up to walk increasing distances. Surgery was 75 days ago now, and I feel relatively unlimited in how far I can walk; foot gets sore after several miles but I can still walk on it. Doctor told me to expect to be back to "90%" three months after the surgery (right when I start on the AT), so I'm well satisfied there.
"The other concern is that in the surgery they don’t just remove the nerve but cut the tendon that runs across the metatarsal bones to spread the bones and prevent a recurrence, and I’ve read this can result in some loss of forefoot control. Have you experienced this?"
My foot doctor talked about this, and that the nerve in some cases can grow back some too — which apparently can be really painful. He said it's never happened to his patients in years of doing the procedure, perhaps because he stretches it before cutting … I don't recall the exact details. I don't feel huge loss in forefoot control. It's still not entirely "normal", but it's already better than it was pre-surgery, and the feeling of numbness is (very) gradually going away.
"You should definitely see one to help you make a good long term orthotic for both feet, even if you had the surgery already."
I had a custom orthodic before I got the Neuroma.
"Which Golite model do you use?"
I was wearing Sundragon II's on the PCT (when I got the injury). They don't make these anymore; for the AT I have a collection of two pairs of Sundragon II's left, a pair of Versa Force with a few more miles left in them, and some plain old "Force" models. The Versa Force doesn't LOOK like it has as wide a toe box as the others, but doesn't seem to cause me any problems; it's lighter than the Force and the "runners heel" thing didn't ultimately bother me at all, so I wish I had bought more of those.
"Jump school is quite an experience. Had a blast with my buddies. However, regular circular military chutes drop you like a lead rock. Civilian jumpers don’t realize what an impact it is."
Indeed — I used both the really old "Haul on the risers" type and the (then) newer T-10 with the toggles which were definitely nicer, but as you say, with both I was fully capable of a classic (high impact) feet-ass-head landing despite brutal repetition of PLF drills by sadists in black baseball hats! :-)Feb 8, 2010 at 1:57 pm #1571253
@jdw01776Locale: Southeast Texas
A bit late responding — I've only seen the Adidas Supernova Riots in D width, but the forefoot is wide.
I remember reading in the "Complete Walker", that the ideal last for hiking footwear was the Munson last, which features wide forefoot and toebox…Feb 28, 2010 at 1:38 pm #1579765
Never see an inexperienced podiatrist. Doctors have to get practice and experience but let them practice on someone else. Also better if you can see a podiatrist that is a sports specialist used to working with active people and athletes.
Also it's helpful if you have a good pedorthist who can help you choose and then customize shoe fit with your orthotics or off-the-shelf footbeds. Unfortunately the best one I know is across the country, but he's helping with suggestions remotely for now.
Found out through MRI that I have what's called 2nd Metatarsal Phalangeal Joint Stress Syndrome along with the Morton's neuroma – a torn/stretched ligament around the 2nd toe joint which may have caused the Morton's neuroma by leaking fluid from the joint and rubbing the bones against the nerve. Trying to get the inflammation down with oral anti-inflammatory (Advil) for 10 days, ice 10 min 2x/day and PT (ultrasound and other anti-inflammatory) for a few weeks and then take it from there.
There's no way to tighten up a ligament without surgery, but before reverting to surgery I'd like to see how things feel once I take every non-surgical course of action to reduce the inflammation.
Switched to doc who heads the podiatry group in our med center and he's much better than the young very inexperienced doc I first saw, but still may not be as good as the sports podiatrist friends and my PT suggested.
Found out from the more experienced podiatrist that first doc should have never given me a cortisone shot for the neuroma – most podiatrists like to avoid this in active people and athletes because it can loosen the ligaments and dissolve the fat pad – sure enough within a few weeks after the cortisone shot I felt pain in the base of the 2nd toe from the stretched ligament right near the injection. The injury could have been there but not as bad and the cortisone shot made it worse. Also he was shocked that the less experienced podiatrist gave me Large metatarsal pads as they are made for someone very heavy with a giant foot – I'm 6 ft 185lbs and he wouldn't give me anything but a Small (fortunately I had the sense to demand Medium pads before he ever pointed this out). He also told me to tape my 2nd toe to the 3rd and 4th toes when walking/hiking to stabilize it. The less experienced doc made a whole bunch of other mistakes and omissions in treatment.
Doc gave me Spenco Rx Arthritis Foot Beds (just a well-cushioned footbed with a good arch) with small metatarsal pads stuck on in the center forefoot behind the metatarsal bones, to help spread the bones from the nerve.
Confirmed my foot size has not changed – still 11D, with left foot almost 1/2 size smaller. I usually wear 11.5 running shoes and trail shoes. So I don't need a wide shoe unless the shoe is cut narrow, as many are – just need a wide forefoot/toe box in a shoe with good torsional rigidity.
My left foot is uncomfortable but I'm still walking at least 1 hour per day and hopefully going for a short hike this afternoon. I'm being careful but stopping all walking would be the worst course of action.
If anyone has had this injury appreciate your input.
Also if anyone sees the AT Plus anywhere, or has any other shoe suggestions, please give me a heads up.Feb 28, 2010 at 1:55 pm #1579771
"Indeed — I used both the really old "Haul on the risers" type and the (then) newer T-10 with the toggles which were definitely nicer, but as you say, with both I was fully capable of a classic (high impact) feet-ass-head landing despite brutal repetition of PLF drills by sadists in black baseball hats! :-)"
Boy, does that bring back memories! We used T-10s (which I remember as the haul-on-the-riser type), and then the toggled (dash)1Bravos (with the small cutout in back), when I was jumping (80-87). But I'm old and my memory is foggy!
WHAT DO YOU WANT TO BE!
All the way and then some sergeant, Airborne!
HOW FAR IS THAT!
Sick, lame, lazy Airborne crazy sergeant, Airborne!
Ah, those were the days! One memorable pre-jump: I was jumping with the 82nd Chorus, and one guy was stoking a cigar and walking back and forth on the shelf between benches at Green Ramp (Pope AFB) singing "Blood on the Risers." Classic!
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