Morton’s Neuroma is one of those foot pathologies that we learned about briefly in Massage Therapy School but it took years before having an opportunity to treat a client who was actually experiencing it. I would soon learn that Morton’s Neuroma is a very common condition of the foot and women experience this condition 8 to 10 times more than men dol. The cause is not entirely known but for a series of unfortunate events and aggravating stimuli, some people develop this painful condition and others don’t. The digital nerve between the third and fourth toes becomes compressed and swollen. The inflamed nerve runs beneath the ligament of the toe and becomes further irritated by rubbing against it due to lack of space. Et voila, the myelin sheath (tissue surrounding the nerve) between the 3rd and 4th toe develops fibrosis (hardening of the tissue) at the area of irritation.
Initially, the digital nerve becomes compressed for any of the following reasons.
- wearing high heel shoes
- high impact sports
Pain is elicited when the nerve is compressed.
- aching and burning sensation in the forefoot
- pain referring towards the outside of the lower leg
- rest and cold foot baths
- wearing wider shoes or box-toed shoes
- limit high impact activities which compress the nerve
Treating Morton’s Neuroma With Therapeutic Massage
Massage is considered a “conservative” treatment for Morton’s Neuroma and should be explored before other “not-so-conservative” options.
***You should refer your client to a chiropodist or orthotics specialist while they are undergoing massage treatments. Client may need orthotics or a pad to splay the toes out for increased comfort.
Morton’s Neuroma Exercises
Manual Plantar Fascia Stretch
- hold heel in one hand and ball of the foot and toes in the other
- pull the toes towards your shin to stretch the fascia along the bottom of the foot
- hold 20 – 30 seconds
- facing a wall, place your hands on the wall in front of you at about shoulder height. Bring one foot back to stabilize your form.
- bring the effected foot towards the wall and place the bottom part of the forefoot and toes on the wall in extension
- bend your knee and lean in towards the wall. You should feel a stretch along the bottom of the foot. Hold 20 – 30 seconds
- if stretch causes pain in area of Morton’s Neuroma – DISCONTINUE STRETCH
Contraindications To Massage
- uncontrolled diabetes
- vascular dysfunction
Other treatment options for Morton’s Neuroma
Morton’s Neuroma sufferers may have to explore other options such as Ultrasound, Corticosteroid Injections, Sclerosing or Alcohol Injections, an in some cases Surgical Neurectomy.
Sources: http://www.drpribut.com/ sports/spnerve.html www.orthoinfo.aaos.org