I did whack 1 toe compartment off of each of my spacers so I could tolerate wearing them in my cycling sandals. I used several other of McClanahan’s scissor tricks to modify the spacers to my feet. He gives guidance on nipping them in a YouTube video you can access from his website.
Years before I saw McClanahan, I bought single toe spacers from a pharmacy. I wore them between my big toe and the second toe in cycling sandals and even they were enough to reduce my bunion and Morton’s neuroma pain somewhat. They were especially helpful in combatting the stiffness of new cycling sandals.
Properly placed metatarsal pads.
Metatarsal PadsMcClanahan frequently prescribes (and sells) metatarsal pads which are placed in the shoe to relieve neuroma pain and solve other problems. They are tricky to place correctly and the self-adhering sticky stuff isn’t hefty enough to use in my hiking sandals but I believe that they are a good strategy.
About 25 years ago I had orthotics made with metatarsal lifts to ease my neuroma pain. The idea is to spread the bones by lifting the middle of the ball of the foot a bit. When I decided to ditch the orthotics, I made little mounds that I duct taped into my cycling sandals to slightly dome my forefoot more aggressively than metatarsal pads would do. I variously used thick leather and silicone gel pads and stacked about 3 layers of the material, with each upper layer being a smaller diameter than the one below. Needless to say, it took a lot of experimenting to get the right shape, thickness, and placement but alleviating the horrible pain was my guide. (I haven’t purchased new cycling sandals for several years but in the past, the ones sold by Nashbar were significantly more comfortable than the Shimano brand for my Morton’s neuromas.)
Braces for Bunions
I’ve also used inexpensive plastic braces for my bunions. The packaging recommends using them while you sleep but that was a non-starter for me. They looked like they’d snap or come off when I rolled over. I’m also sleep-challenged and the generally uncomfortable nature of the braces felt like a prescription for insomnia. I’m not a fan of them but I do use them during waking hours from time to time. Oh, and don’t even think about walking with them on.
A QUICKER FIX WITH MFR
Broadly Applied TherapyMy 2016 cure-all for all of my muscle/joint/athletic performance issues was do-it-yourself myofascial release (MFR) using assorted firm balls to apply as much pressure with them as I could tolerate to the afflicted areas. I was quite surprised to see my feet almost change before my eyes when I aggressively began using MFR on them in the summer of 2016.
The slow part of the MFR project that I didn’t recognize was benefiting my Morton’s neuromas was working on the backside of my lower body. Because of the way the nerves in the feet are wired up, stretching and massaging the glutes (the big muscles in the buttocks), the hamstrings (back of the thigh muscles), and the calves can all take some of the tug off of the painful foot nerves.
Using 2 balls to mobilize tissue using "smashing" technics.
I shifted from emphasizing my quads during my myofascial release or ‘smashing’ sessions to those ‘backside’ muscles in March of 2016 and that work undoubtedly contributed to the improvement in my feet. I’ve received a lot of sport massage work over the decades but the smashing was clearly a new modality with different and needed effects on those tissues in me.
Targeted MFRThe almost-before-my-eyes change in my feet occurred when for some reason I decided to aggressively start smashing the tops of my feet—the usual treatment strategies for my problems were always for the bottoms. We only had 2 balls with us at the time and I positioned the smaller, softer T-ball on the floor and under the ball of my foot so my toes gripped or curved over it while I was seated on a chair. I’d bend over, resting my chest on my thighs, and apply all of my available force to the top of the foot through our 5” hard foam ball though the size of the ball doesn’t matter.
I slowly rolled the ball with intense pressure across my toe nails and then worked my way across the length of my toes. I crossed the knuckles at the junction of the toes and foot and continued working crosswise to the ankle. I’d then slowly work the foot length-wise, especially between the bones of the foot. That’s when I realized that I might be able to further open the space between the toe bones to take even more pressure off of my Morton’s neuroma. I was no longer wandering and exploring, I was suddenly on a search-and-destroy mission and feeling the benefit almost as I did the work.
"Scraping" the top of the foot for Morton's neuroma MFR.
The smashing on the tops of my feet was less painful than the work I’d been doing elsewhere in my body but I could feel that it was equally effective—I could immediately feel subtle but welcome relief in my feet. After several days of this aggressive smashing, we happened to ride our bikes, an activity that readily triggers my neuroma pain because of the rigid cycling sandals with the dreaded toe spring. Even after hours of high-power transfer through my feet on my loaded bike in the mountains, I was pain free. I was optimistic that I’d never feel my Morton’s neuroma pain again.
Excited about my rapid progress with my Morton’s neuromas, I went after my bunions. I used the exact same positioning of the balls but draped my big toe a little bit down the side of the T-ball. Because my bunions are in remission, I was able to apply pressure on the bunion area itself and then worked diagonally and longitudinally over the top and outer edge of the toe. I envisioned stretching and lengthening the soft tissue on the top and side of the entire length of the big toe. The work wasn’t as startling as with my Morton’s neuroma, but it seemed to make my big toes a little more comfortable, a little more mobile. Placing a thumb or silicon toe spacer between the big and second toe helped stabilize the big toe while I worked the thin layers of tissue.
It’s highly likely that smashing was immediately perceivably effective in decreasing my issues with Morton’s neuromas and bunions because I’d already done decades of other interventions. But maybe, just maybe, others can measure their relief from these painful foot conditions in months or years instead of decades by using myofascial release from the outset of their foot rehab program.
Two More TechnicsI continued my fancy foot work into the fall, finding new ways to work both the bunion and Morton’s neuroma areas.
Morton’s Neuroma MFRSitting on the floor with one supported knee bent into kind of a chicken wing position, I would press and slowly drag a ball on the top of the foot towards the floor like I was scraping it. I’d begin the deep stroke between my Morton’s neuroma foot bones and dragged the skin and ball towards the little toe and the floor. I worked from the ankle to the toes, feeling the variations in tissue density along the way. This seemed to open up the space between these lateral bones even more.
Pressing and dragging the ball to mobilize the tissue around the bunion.
Bunion MFRMassaging and using high-pressure MFR along the side of my arch from the ankle bone to my bunion relieved densities in that area, which includes a muscle that controls some of the big toe movement. The drift of my big toes towards the second toes as a result of the bunions had weakened the big toe muscles in me and the first step to reversing that change was to mobilize the tissues.
STRENGTH WORKPre-WorkWith the big toes moving more normally, I could make faster progress in strengthening their muscles. I worked my big toes in 2 directions: up and down and sideways, which is especially helpful for bunion recovery.
Toe PressesWith my foot supported off of the ground, I commanded my big toe to strongly press downwards, leaving the other toes behind. My left big toe couldn’t budge, but my right one could. I did both brief reps and 10 second holds to both work on the coordination and to strengthen the right foot muscles.
With the learning that occurred fairly easily on my right foot, I returned to the left, insisting that it at least try. Within a couple of days, I had the neuromuscular patterning in place and switched my focus to strength work on the left big toe. Once you can control the movement pattern, you can do your toe presses almost anywhere, like sitting in a car.
Toe presses to strengthen specific foot muscles.
Toe SlidersHarder for me was opening my big toes away from their second toes and towards each other. In the air or on the floor, command your big toe to move sideways, not up or down, but sideways. Again, this was more possible with my right big toe, so that is where I started each session.
Bill discovered a nifty assist if the big toes just don’t budge, which is to press a thumb or finger into the side of the arch a little way back from your bunion towards the ankle. Here you will find the muscle you use to both slide and press with your big toe. For me, being able to feel the muscle contractions under my thumb was my first measure of success even though the toe didn’t visibly move. I settled for that as positive reinforcement until a toe actually started moving. Progress for me on this movement was measured in years with my left toe whereas the toe presses nicely progressed in days.
REVITALIZING YOUR FEETMy first yoga teacher used to say “People die from the feet up.” I didn’t really get it, but it was such a strong statement that I retained it. Now, many years later, I get it. I can see the deadened, detached relationship that some older people have with their feet. Their feet are almost treated as ‘other’ rather than a part of themselves. Their feet become an ever increasing source of pain and ailments and the lack of the mobility in the feet could contribute to falling. My slow progress in reducing my foot pain and making my feet more vital by embracing minimalist shoes since 2009 has convinced me that dying from the feet up isn’t inevitable, that my demise will come but not from my feet.