Morton’s neuroma is a painful condition affecting football; it often arises from nerve compression between the toes. Manual therapy, including osteopathy,  can be an effective, non-invasive approach to managing symptoms, offering relief by reducing pressure on the nerve and decreasing healing time. This article is based on a self-help YouTube video I filmed live with an online client. After doing these exercises for a few weeks, her foot completely recovered.  If you would like to follow the video, please click here.
 

What is Morton’s Neuroma?

Morton’s neuroma occurs when the nerve between the toes becomes irritated, often due to tight footwear, repetitive stress, or biomechanical imbalances. Symptoms include:

• Burning or shooting pain in the ball of the foot.
• Tingling or numbness in the toes.
• A sensation of a pebble under the foot.

After removing the initial cause—many times a change in footwear or a sudden increase in activity—use manual therapy to address the symptoms by improving the structural alignment of the foot and reducing soft tissue tension.

Manual Therapy Techniques for Morton’s Neuroma

Soft Tissue Massage 

Gentle massage around the affected area can help release tension and improve circulation:

• Technique: Use your thumbs to apply circular pressure to the ball of the foot and the spaces between the toes. Work between each toe to increase the space between the bones in your mid foot, called metatarsals. 
• Benefit: Relieves tightness in the plantar fascia and surrounding tissues, reducing pressure on the nerve.  

 

Metatarsal Mobilization

Mobilizing the metatarsal bones can relieve compression of the nerve

• Technique: Gently grasp the foot and move the metatarsal heads apart using a spreading motion.
• Benefit: Creates space around the nerve, alleviating irritation.

 

Toe Stretching and Alignment

Stretching the toes helps reduce tension and improve alignment:

• Technique: Hold the toes and gently pull them apart and backward to stretch the tissues.
• Benefit: Reduces strain on the nerve and improves flexibility.

 

Myofascial Release

Targeting the connective tissue can relieve deep-seated tension:

• Technique: Apply slow, sustained pressure along the foot arch using your fingers or a massage ball.
• Benefit: Releases tight fascia, improving overall foot mobility.

 

Self-Care Tips to Enhance Manual Therapy

1. Footwear Choices: Wear shoes with a wide toe box and adequate arch support to reduce compression on the nerve. I like vivobarefoot shoes and Birchbury. I especially like Birchbury because their shoes look ‘normal’, and I’ve worked with their owner, so I know the passion that goes into their shoes. 
2. Stretching Routine: Incorporate daily stretches for the calves, arches, and toes to maintain flexibility.
3. Use of Insoles: Orthotic inserts can help redistribute pressure away from the neuroma. This is best done with the supervision of a foot specialist.  Don’t fall for expensive rigid insoles, though; all you need is an insole that lifts the ball of your foot and helps your foot expand.
4. Cold Therapy: Apply ice packs after manual therapy to reduce inflammation.

Manual therapy is a powerful tool in managing Morton’s neuroma. Soft tissue massage, metatarsal mobilization, and myofascial release can relieve pain and improve foot function. Combine these with proper footwear and regular stretching for lasting relief. By addressing the root causes of nerve compression, you can take significant steps toward a pain-free life.

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