วีดีโอ

Yes , I like this shoe. It’s good providing your calf flexibility is ok

Fair point ! Taken to extreme with high heels. Hard unnatural surfaces are also an issue - I see a lot of dancers with Morton’s neuroma who dance in bare feet . Few more brands now producing foot shaped shoes. Fitville looks interesting with good feedback from patients

@@FootExpert360 Thank you. I found the Altra Paradigm 4.0/ 4.5 were the best running shoe I have run in to almost remove the pain from my 'self-diagnosed' Morton's Neuroma (3rd/ 4th toe intermittent interstitial 'pebble' - right foot). I'm no expert so may well be wrong, but still the Altra's still seem the only realistic choice of running shoe for me to stick with - albeit somewhat downhill in terms of toe pain again since they introduced newer 'improved' versions with different characeristics of cushioning, stability, etc.

Thank you so much for your questions about Birkenstock sandals! First off, Birkenstocks can work beautifully for some patients, while others may find them less suitable. The key factor is the built-in arch. For some, the arch hits just the right spot, providing excellent support. For others, it may not align as well, making them a bit more difficult to tolerate. Another consideration is that Birkenstocks are quite flat, which can be a challenge if you have tight calf muscles. That being said, Birkenstocks are often very well tolerated by patients with Morton’s neuroma. This is largely because they allow the foot to splay naturally, which helps reduce side-to-side compression-one of the leading causes of Morton’s neuroma, as it can trap the nerve. This is why sandals, in general, tend to feel more comfortable for many people with this condition. If you’re considering Birkenstocks, I recommend opting for a style with a back strap, which provides better support. Keep in mind that wearing sandals over long periods can sometimes cause your toes to claw, as your foot works harder to keep them on. In answer to your question, Birkenstocks certainly don’t cause Morton’s neuroma and, in many cases, can provide relief. However, there are even better footwear options for daily wear. Especially during winter, a closed-in shoe with a wide toe box would be a great choice. Look for shoes that offer the same foot-splaying benefits as Birkenstocks, like those from the Altra range or FitVille which provide excellent width. I hope this helps! Remember, finding the right shoe can make a world of difference, and you’re taking the right steps in caring for your feet. If you have any further questions, feel free to reach out. Warm regards, Ron McCulloch

Thank you so much for your question. I completely understand your concerns, and I want to reassure you that cryosurgery is not a temporary solution. I’ve been performing this procedure for 13 years, and the majority of patients don’t need to return for further treatment. While a few may come back, this is quite uncommon. Regarding numbness, it’s important to note that permanent numbness is not a typical outcome of cryosurgery, but in rare cases, it can occur. In contrast, open surgery almost always results in some degree of numbness. That said, most patients find that if there is any numbness, it’s minor and only affects sensation between the toes, without impacting their overall function. I hope this helps put your mind at ease. Cryosurgery has a success rate between 70% and 80%, and I’ve seen great outcomes for many patients, especially when factors like associated deformities are managed effectively.

Yes HOKA can be good. I specifically recommend carbon shoes, when the patient has great toe joint stiffness with weight transfer onto the site of the neuroma. They definitely have a role depending on the specifics of a patient foot type. The HOKA Cielo x1 is an interesting shoe !

Definitely. There are two key considerations . You need to have reasonably good calf flexibility to wear them. If you have evidence of excessive pronation then I think the Altra Paradigm is good ! I have done videos on this !

Hi there. For trainers I recommend Run and Become in Victoria London, For Xsensible shoes and good walking shoes I can recommend. Precious Soles in Potters bar, London. Sketchers are widely available. Functional 3 swimming shoe is available on Amazon. Most of the shoes are easily found with a Google search.

I am not sure, but I have seen quite a few patients from Canada who have flown over to see me in the UK. I do online consultations.

The Greek foot poses a significant risk to Morton's neuroma. Especially between the 2-3 toes. Check out our video on this subject (Foot shapes reviewed) . The Kuru looks well made but we haven't tested it in our laboratory so cannot say more than this at the moment.

Sorry we never got to meet. Hope things are ok now !

Yes this is very frustrating but a sign of the times with so much more mail order shopping. Many of my patients accept the inconvenience of online ordering knowing they can send them back if there is an issue. It is frustrating though !

Most of the shoes are available in Italy on line but I realise that is not necessarily ideal. I wish you success !

I quite like them for the right patient. They are wide in the toes but obviously very minimalistic which can be an issue if you have a lack of padding under your feet or if you walk on hard surfaces. I will soon be uploading a video on off the shelf insoles that can be used with shoes like this so as to offer a bit more protection for those that need it. These shoes offer minimal support which is fine for some but not if you have a flat unstable foot or tight calves !

Good luck ! sounds like you are taking the correct approach ! Fitflops (sandals) are often better than flipflops because of the rocker and increased cushioning

Hi,any improvements ?

So nice to receive this feedback. Yes the Nimbus is a good shoe especially for a more neutral foot type !

Hey,from how long you been facing 😢 this neuroma problem?are you able to manage it?

Hi, the Meindl GTX respond comes in a hiking boot and shoe. It is excellent ! Wide fitting and very stable and has helped many of my patients !

Many thanks for your question. In some cases, two months post-operation might raise concerns about abnormal reactions around the nerve if recovery isn't progressing as expected. This could be due to scar tissue binding to the nerve where it was cut, or a true stump neuroma forming. However, it can sometimes take longer, with three to four months before symptoms of a stump neuroma become more obvious. In my experience, it's rare for patients to fully recover from an operation and then develop symptoms from a stump neuroma. Often, there's an indication of potential stump neuroma development if the patient isn't recovering normally. With open surgery mild to moderate discomfort may persist for up to six months post-surgery, and the full results of surgery can take up to a year to fully realize due to scar tissue remodeling and the foot adjusting to the absence of the nerve. I have not encountered evidence of a stump neuroma with either cryosurgery or radiofrequency to date.

Sorry to read this. I hope that some of my videos help, we regards to to trying various treatment strategies.

I think it’s this one. shoemed.co.uk/products/xsensible-stretchwalker-swx6-cognac?variant=39774911889494&currency=GBP&gad_source=1&gclid=Cj0KCQiA2eKtBhDcARIsAEGTG41kqN2Xbg0tQ_T-x9JxmqcYHEfNEz8PZVPv5TTzh7K14tEo9xISwnEaAjEIEALw_wcB

I agree to a certain extent. Indeed, barefoot shoe technology can be highly beneficial for those with strong biomechanics, particularly when running on natural surfaces. However, it’s important to acknowledge the unnatural nature of concrete and other hard surfaces. Expecting the foot to adapt to such harsh terrain without adequate protection might be unrealistic. Furthermore, biomechanical efficiency plays a crucial role in foot health. Issues with foot mechanics can be the difference between sustaining injuries or remaining injury-free. Drawing from my 30 years of professional experience, I believe in the uniqueness of each individual. Accordingly, treatment and advice should be tailored to meet their specific needs and conditions

Of course - why would any shoe not want to be 'foot shaped' when supposedly designed to fit a human foot - where it would seem that the vast majority of shoes are so pointed that they must surely have been designed to fit a cloven hoof. It's insane! Keeps podiatrists in work I suppose - if you can afford to see them of course. The Altra Paradigm 4.0/ 4.5 was the best running shoe for me to almost eliminate the toe pain - but then Altra decided to make changes for the worse as is usually the case - although still run in the Paradigms with little else to choose from. And then there's the achilles pain on top which never goes away.

​@chriscrumly that is unfortunately the sad truth. Y do you think terms like wide toe box and zero drop sole are not common. Modern shoes are giveing similar results as ancient chinese foot binding. Shoe tips should not be cone shaped. Or your feet might end up similar to Lebron james's

While Sketchers offer advantages, they may not be the most stable choice for everyone, especially for those with very flat and unstable feet. In such cases, a more stable training shoe, like the Altra Paradigm, might be a better option, provided that the individual has sufficient ankle flexibility. This variability in foot structure and needs is why I advocate for personalized shoe recommendations. There isn’t a one-size-fits-all solution in footwear, as each individual’s requirements are unique.

They certainly set off my planar fasciittis a few years ago, and I'll never wear them again. Morton's neuroma though is really caused from arch collapse. Certain shoes will only make it worse.

I think it happened to me, helped me with other issues but contributed with My Neuroma very likely

I also felt it when using these shoes

Thank you. I am literally on the edge of getting surgery because this has ruined my life for the past 3 years. Thanks for the advice I will take it

Why?

It’s all about weighing up the pros and cons. The obvious approach is to try the safest approach with the least risk of complication. I perform open surgery when necessary, but by minimising the number of open procedures I do, choosing minimal invasive approaches whenever possible, I keep my complication rates very low. Open surgery, works for the majority of patients, but if you have a complication like stump neuroma it can be very challenging to manage.

happy to see you in London, but I appreciate that might not be practical. I can recommend the following Dr in the USA. orthopedic.io/podiatrist/dr-peter-a-wishnie-dpm-piscataway/

Yes, in some cases, Morton’s Neuroma can improve without targeted treatment, depending largely on the specific circumstances of each case. The outcome often hinges on factors such as the size of the affected nerve and the extent to which it has become thickened or fibrosed. Typically, a notable lifestyle adjustment is necessary for a chance of spontaneous recovery. For instance, if activities like dance and yoga, which are known risk factors for Morton’s Neuroma, are a regular part of your routine, ceasing these could potentially allow the condition to resolve on its own. Similarly, occupational factors can play a role. If your job involves prolonged periods of standing in high heels, a shift to a role that allows for more comfortable and foot-friendly footwear, such as wide shoes could lead to significant improvement. This adjustment could give the nerve the relief it needs to recover. In my professional experience, appropriate guidance and advice can sometimes be all it takes to alleviate symptoms. However, it’s important to recognize that for many individuals, making such radical lifestyle changes isn’t always feasible or practical. Each case of Morton’s Neuroma is unique, and what works for one person may not be suitable for another.

For some people, a steroid injection will last longer than others. If the problem is due to a lot of inflammation around the nerve, rather than thickening, there is more chance it will work longer term. Try and vary your terrain as much as possible. Take a look at some of my other videos for things to try. Consider ToeToe socks which can help.

Yes, this is a valid consideration. That's why I've suggested a variety of footwear options. If your foot tends to pronate and lacks stability, a shoe offering enhanced support is advisable. For instance, the Asics Gel Kayano is an excellent choice. Alternatively, a shoe, such as a Sketcher, may suffice if paired with a quality orthotic. A skilled podiatrist can create a custom orthotic that includes memory foam for added comfort. Regarding excessive foot perspiration, regular use of a potent foot deodorant is recommended. It's crucial to keep the areas between your toes dry. Additionally, there are commercially available devices that pass a mild electric current through the feet to significantly reduce sweating. These devices have proven to be highly effective.

You are welcome!

good luck !

I would agree that it’s always best to start with the least invasive and safest procedures. Open surgery can work well, but leave it as your last option because of the risk of complication.

Many thanks for feedback. Yes this can be a problem. Especially if your heel is a certain shape. There is a special lacing system that can help to keep the heel back and secure and I will show this in one of my next videos. The other option is that the Altra has quite a good insole that you can remove. if you replace it with a thinner one, then you can add some heel lifts and your foot will be slightly lower in the shoe. However the reality is that not all shoes work for everyone. I’m glad you found a solution with the ortho Feet. This shoe is not as stable as others, but we are going to do more testing as it does have some interesting features.

Very sorry to read this. I don’t believe Professor Wishnie is too far from you and he has a very good reputation. Maybe he can help. Link: raritansurgery.com/physicians/bio/wishniepeterdpm/ Sorry you are so far from my clinic.

I'm truly sorry to hear that cryosurgery didn't bring you the relief you were hoping for. I presume you had it done in the US where the procedure is more common ?It's important to remember that each person's journey to healing is unique, and what works for one may not work for another. This is precisely why we offer a range of treatments. Cryosurgery, while effective for many, isn't a universal solution, and understanding this is key in our approach to patient care. I plan to discuss the various reasons why different treatments work for different individuals in a future video. It's a complex topic, and I believe it deserves thorough exploration. I've seen first hand how cryosurgery has positively impacted the lives of hundreds of my patients. However, I also recognize that it's not always successful, and acknowledging this is crucial in practicing compassionate and effective medicine. Safety is always our foremost concern, especially when comparing cryosurgery to other procedures. Personally, if I were faced with Morton's neuroma, I would choose cryosurgery as my first line of treatment. It allows for continued daily activities and, in my experience, the risk of complications like stump neuroma is extremely low. In fact I have never seen it with cryosurgery. I want to encourage you to remain hopeful. Finding the right treatment can be a journey.

Yes, it can really play havoc with your life, and I'm sorry you're suffering. One of the challenges is that not all neuromas are symptomatic. We often see them incidentally, and it's only if they reach a certain size or level of irritation that they become problematic. That's why you can't rely solely on the scan. It's very much a case of marrying up the scan with the clinical examination. It's not uncommon for practitioners to treat a neuroma that isn't actually causing the problem. I hope my videos are helpful, especially in allowing you to find a conservative solution. The right choice of shoes can really make a significant difference.

Ive booked myself in for a consultation, hopefully you guys can help me @@FootExpert360

Thanks for comment. Morton’s Neuroma rarely occurs between the fourth and fifth toes, a situation I’ve seen only twice in 30 years. Confirmation via ultrasound is essential. The Brooks Ghost Trainer suits a neutral foot, but effectiveness varies with foot type. If orthotics and shoes aren’t helping, alternative treatments should be considered. Our lab’s detailed orthotic analysis, using hundreds of sensors, could offer more insight. Given your current discomfort, a review of your orthotics and possibly a different shoe type might be beneficial. For more detailed advice, please feel free to contact our practice - 02082979631. Good luck !

thanks very much, so an ultrasound rather than an MRI?? I plan to go to my GP soon with this for a definite diagnosis (Im in Ireland)@@FootExpert360

I did not even develop a Morton’s neuroma until I started wearing Brooks Ghost. It could be a coincidence but they now cause more pain that any other shoe.

Thank you for your video. I wish you worked for the NHS . I waited 4 months for a physio appointment to be told ignore the numbness and not worry about it! I recently went to see a private physio who so far has been very helpful in Cambridgeshire. I wanted to buy Sketchers but l am unsure which ones to buy .

Hi Chris. Thanks very much.

My pleasure :-)

Glad it was helpful!

Hi there. So pleased the videos are helpful. sorry to read about your insurance situation. Hopefully some of my advice will make a difference.

that's very kind

Glad you liked it!

Yes, and I’ve done a dedicated video just on this. You should find it on my channel.

Hi there. The symptoms have to fit. One way is a local anaesthetic diagnostic injection. if you block the pain temporarily with local and it goes then it must be the neuroma. ! If it stays, its something else. Also the clinical exam will generally tell you.

about 40 minutes to two hours as we do different types of gait. Please see gaituk.com our web site on this topic

around 70-80% but it depends on various factors.

to minimise swelling by optimising function of veins. you only need to do this for 24 hours

Much appreciated!