What is it?
Morton’s Neuroma; a trapped or pinched nerve between the metatarsals.
What are the common symptoms/complaints?
Sharp pain between the shafts of the metatarsals, numbness and tingling sensation that radiates through the toes.
How is it caused?
The most common causes for neuromas are tight fitting shoes, high heels and over-pronation. With over-pronation, a pivoting on the 3rd and 4th metatarsals can cause a shearing force. This shearing force between the 3rd and 4h metatarsals entraps the digital nerve and causes inflammation. The inflammation is the source of pain.
How is it treated?
Morton’s Neuroma pain can be momentarily relieved by massaging the affected area. Control of the abnormal transverse plane motion of the foot is successful in reducing the symptoms associated with a neuroma. Orthotics should be prescribed, as they will help to diminish excessive transverse plane rotation between the medial and lateral columns of the the foot, reducing pain and inflammation caused by Morton’s Neuroma.
The piriformis muscle originates on the sacrum and crosses over at a slightly downward angle to the outside of the hip, attaching to the lateral side of the femur. Its function is to laterally rotate and extend the hip joint. Piriformis syndrome is a condition in which the piriformis muscle irritates the sciatic nerve, causing pain in the buttocks and referred pain down the leg along the path of the sciatic nerve.
How is it caused?
If the leg has been externally rotated for an extended period of time, such as driving long distances, the piriformis muscle can shorten. Continual internal rotation of the femur (result of prolonged pronation and poor foot mechanics) can cause the piriformis muscle to overwork and therefore increase in size. In both instances, when the leg tries to straighten out during activities like walking, the involved muscle compresses the sciatic nerve.
Treatment
Stretching of the piriformis muscle is necessary. Massage is helpful in relieving tightness. Faulty pelvic and foot mechanics need to be addressed. If internal rotation of the femur and prolonged pronation is evident, an orthotic device should be prescribed to prevent over-pronation and control the leg from internally rotating too much and too long.
Calluses
Callus is an area of thickened skin tissue on the bottom of the foot due to irritation. Calluses are localized in high friction areas, typically under bony prominences.
How is it caused?
The integrity of the protective barrier the skin provides the foot is critical in maintaining weight-bearing function. Callus formation occurs in areas of high vertical and shear loads and defends against blistering and ulceration. However, this process itself can cause symptoms and predispose patients with poly-neuropathy to deep infection. Even in a so-called “healthy†foot, poor foot function can lead to callus formation. During over-pronation, the foot rolls across the metatarsal heads—one at a time—distributing the weight unequally. This happens because the foot is unstable, with over pronation causing hypermobility of soft tissues. Prolonged over pronation will cause the skin to be trapped between the bones in the foot and the ground; concurrently, the friction of individual metatarsal heads, bearing all the weight, can cause inflammation. The skin thickens in the inflamed area to protect the sore spot. This thick build up of skin so close to the nerve endings in the bottom of the foot is what contributes to the pain.
Treatment
Soft tissue care and maintenance is recommended. However, since the problem is high vertical and shear loading your patient will benefit from Footmaxx orthotics to properly redistribute plantar pressure. Within weeks, your patient will likely feel pain relief. The calluses can be cut away or will eventually go away on their own once the irritation no longer exists.
Call for your free Footmaxx Gait analysis 604-270-1007.
Shin splints are small tears in the area where the lower leg muscle attaches to the tibia, aka the shin bone. The tears result from overuse, and since pavement taxes your muscles more than a treadmill, many runners complain of shin pain when they first begin outdoor runs. Shin splints often occur because the calf muscle becomes stronger than the tibialis anterior, the muscle on the outside of the shin. Even if the ache isn’t that bad, it’s still a minor injury. Pushing through the pain could result in more severe tears — an injury that could sideline your running routine altogether.
Keep reading to learn how to prevent shin splints.
Check your form: Are you a heel striker? Landing on the heel can result in shin splints splints, knee injuries, or a pulled calf muscle. To prevent shin pain, focus on landing midfoot rather than on the heel.
Strengthen the lower leg muscles: Since shin splints can be caused by muscular imbalance, strengthen the muscles in the lower legs by doing variations of walking on your toes and heels as well as this seated shin-strengthening exercise using a dumbbell.
Run on softer surfaces: During the Winter, this might not pose as big of an issue, but pavement is hard on the joints and muscles. As opposed to asphalt, running on dirt roads or woodsy trails could eliminate the pain immediately.
Don’t skip stretching: Make time for stretches that target the lower legs, including these seven calf stretches — even on days you don’t exercise — and this yoga pose that stretches the shins.
Don’t just run: Cross-train with other types of exercise to strengthen all your muscles and to maintain flexibility. Bike, swim, hike, walk, do yoga, and hit the weight room at your gym.
Rest: Some days of rest are in order, but that doesn’t mean you have to stop all physical activity. Do low-intensity exercise that doesn’t aggravate your shins, such as walking or swimming laps. If resting doesn’t help, then make an appointment with your doctor to ensure it’s not something more serious like a stress fracture.
Ice, ice baby: Taking a full ice bath may not be the best idea during the colder months, but using an icing cup for massage protects your fingers from freezing and provides a perfectly sized contact point for troubled shins.
Roll out: A foam roller can be part of your best defense against shin splints. When you feel the pain start, this simple foam rolling move can ease the ache.
Add an incline: Running on flat or downhill ground can make you more susceptible to painful shin splints by putting pressure on your shinbones, but running uphill can alleviate that stress (just be careful when you head down!).
Ease into outdoor runs: Once the weather warms up, don’t expect to be able to run at an eight-minute-mile pace for 45 minutes straight like you could on the treadmill. Wind resistance, uneven terrain, and the lack of a moving belt to propel your steps makes for a much harder workout. Doing too much too soon is a surefire way to end up with shin splints or another injury, so slow down your pace, run shorter distances, and don’t be ashamed to take walking breaks when necessary.
