Mortons Nueroma or something else?

[Karl Bedingfield]

Hello all,
I saw my podiatrist today and he tells me I have MN of the 1st & 2nd toe but I am not convinced.

Heres what happend: I was running on Monday night quite comfortably but some runners in front of were running slower than me on a downward hill which caused me to break by going up on my toes.
I continued running and all seemed fine but about 3/4 of a mile I felt I had a stone in the shoe of my right foot that was aggravating my second toe. I stopped, took my shoe off and sock but nothing was in there.

Now 10 days later everytime I put direct impact with the floor at mid-stance and during push off my 2nd toe has a sharp tingling feel at the very end of the toe.

I can stand on the balls of my feet just fine (like when doing calf raises), I can bend every toe without pain, when I squeeze my foot, no pain. In fact I can do anything to the foot with no pain, even pushing the metatarsal head of second toe.

If I put my fingers between the webbing of the 1st & 2nd I can bring the tingling on.

On close inspection I noticed that when I pit my foot flat down all the toes are touching the ground apert from my 2nd which is elevated a little off the ground.



I have had an x-ray and my Doc says there is not break/fracture.

I did try this taping method which did take a lot of the sharp pain away - http://www.aptei.com/library/viewReport.jsp?report=431

Is this MN or may I have just strained?

Any help greatly appreciated.

Thank you

 

[Backfixer]

My first guess is that there is an entrapment in the anterior compartment of the legs of the toe extensor for the second ray. I see this alot with people who have shin splints. While taping may help, it will not resolve this. My suggestion is to find someone who can do myofascial release in the area and release the muscle. The problem sounds like tendonosis, and as far as entrapment goes, there are nerves that traverse these tissues that may account for the tingling into the toe.

You can try working this out with a foam roller on the muscles in the shin gently.

 

[Antonio Madriñán]

I hope it's nothing, I say nothing I do not know enough about the subject, perhaps some tendons

 

[Dr Emily Splichal]

Hi Karl -

I actually disagree that this is an issue of your anterior compartment - although the nerve that supplies the 1st interspace between your first and 2nd digit travels through the anterior compartment - this sounds like it could be a neuroma type pain or a inflammatory reaction directly related to your 2nd digit.

Did the Podiatrist do an US of your foot? A neuroma can easily be visualized on the US. The neuroma in the 1st interspace is called a Joplin's Neuroma. If NO neuroma shows up then you start looking at other causes - such as an issue with the 2nd digit - or as Dr Charschan suggested the anterior compartment.

The picture you attached where the 2nd digit does not touch the ground is actually very common - this is the early signs of what is called pre-dislocation syndrome. The area of the foot with the highest pressure is the 2nd metatarsal - which leads increased stress into the 2nd toe joint. Over time this weakens the soft tissue structures that stabilize the joint.

Where did things leave off with the Podiatrist?