Morton’s neuroma and biking for GPP LISS

Ten years ago or so, I really enjoyed biking a lot, but I stared to get a pain between the middle and “ring finger” toe on my left foot when I had been riding for a couple of hours.

I tried different shoes to no avail, and went to an ankle and foot specialist, and he diagnosed a neuroma in my left foot. He tried cortisone injections, and when that did no work, he suggested injecting alcohol to kill the nerve - “sclerosing”.

I declined killing the nerve and rode less, I was also hit by a car at the time - not badly heard, but sort of phobia now about cars.

I stopped riding, and the pain mostly stopped.

I do a fairly vigorous kind of social dancing - called “contra dance” - and the toes will occasionally bother me if I dance for more than 3-4 hours.

I kept in mind the advice I had heard about wider toe boxes in my shoes, etc., and I switched over - pretty much exclusively to Vibram FiveFingers 7 or 8 years ago. I don’t think that restrictive shoes are the issue anymore.

I started the Beginner template a could of weeks ago, and I pulled out my old bike for GPP LISS work.

I much prefer riding outside to any indoor work - but last night, I pushed a little harder, and I feel the beginning tingling in my left foot.

Has there been any new treatments developed for Morton’s neuroma in the last decade?

I really don’t want to kill a nerve for what seems to me to be an extremely intermittent problem - I assume that the nerve serves some function, but I would also really like to ride my bike for LISS.

I am 69, if that matters.

Thanks.

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I am a little puzzled by the lack of response.

Has this question been answered previously?

I searched and think that I did not find an answer, but maybe I am wrong?

Sometimes it takes us a minute to get to responses and sometimes posts fall through the cracks.

To your questions, there have not been any new treatment methods for a Morton’s neuroma that have good evidence.

If you have not been on a bike in a while, it is as likely the novelty of getting back into it that is the issue. If you were clipped in and have a hard footplate that can sometimes tilt towards experiencing symptoms a little more as well. Most of the time the treatment does come down to using a wider toe box and working on graded exposure. If I were you, I would track the amount of time prior to onset of symptoms and see how that changes. To your point regarding dancing, if you can ride for 20 minutes prior to symptoms and it increases to 30 minutes, symptoms are still present, but that is progress. I would not recommend the sclerotic procedure but would titrate down the intensity on your rides in the short term and look to accumulate some volume and get your foot used to being on the bike again.

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I can dial back the intensity on the rides for a while.

The first thing I tried was getting rid of clip ons - from what I can tell, there aren’t any clip-on with wide toe boxes.​

I also bought - or at least ordered - an XPO Trainer 2 that I can push in the street in front of my house. Pushing a weighted sled at the gym does not seem to cause any issues.

I guess I should feel lucky - I can still dance for three hours, and some of my older friends could not dance at all until they had surgery - usually removal.

Disappointed that the options with Morton’s neuroma is still cortisone or sclerosis - I had hoped for a different answer.

Thanks!