Morton's Neuroma

Today, I saw my podiatrist, along with a bag of shoes, pedals, and foot beds.  After deep palpation of my 3rd inter-metatarsal spaces, which elicited a few whimpers, my doc said,  "I believe you have a Morton's neuroma in both feet.  I also had the classic gap sign between my third and fourth toes where the fibrotic nerve is so large it is pushing apart my metatarsal heads.

See the space between the 3rd and 4th piggies!

Radiographs ruled out any bony pathologies.  When he placed the ultrasound on the area of suspicion, he outlined the two neuromas.  Basically, the nerve that runs between the metatarsal heads is normally the size of angel hair pasta.  My neuromas, however, are the size of large green peas!  No wonder the pain was so intense!  

Doc then outlines different methods of treatment.  One is a series of 5 alcohol injections over 5 weeks to kill the nerve.  He sees a 50% success rate.  The other is surgical removal.  Two small incisions over the top of the foot, and cut out the offending portion of nerve. No real down time; I could be back on the bike the next day!  The only potential complication is a stump neuroma, which he said happens about 10% of the time.

For the short term, he injected the area with marcaine and dexamethasone, bringing about instant relief!  If you look closely at the picture above, you can see a needle mark on each foot at the 3rd inter-metatarsal space.  I love any doctor that can relieve pain without prescription drugs!

He agreed on all my methods of orthotic management with the wide toebox, the Specialized BG footpeds with the metatarsal bump, and the XTR pedals.  But he said that more than likely, until the neuroma is excised, I will have recurring episodes of pain.

He said the injections could help for 1 week, 1 month, 6 months, or maybe even a year.  We shall see, I guess.  But I am prepared to have those little bastards cut out if necessary.  As much as I am on my feet at work and on the bike when not, I will probably have to undergo the knife in the future.

Today was the first pain free day on the bike since TNGA.  I felt so good I almost cried!  I did not feel every friggin little bump and for once forgot about my feet.  I also tried out my modified Specialized MTB shoes.  I was able to move the cleats back 1 cm with the modification.

I was able to drill out the carbon sole and move the cleat plate further aft.

Riding my SS today, I really did not notice any difference in this new cleat position or power transfer.  It might be more noticeable when riding gears and staying in the saddle more.  I suspect I will have to make saddle adjustments and will defer to Eddie for that.