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Pain in the front of the foot that makes the third and the fourth toes become numb is commonly referred to as Morton’s neuroma. However, this is an extremely rare condition where a bundle of nerves starts to grow like a tumor between the metatarsal heads of the third and the fourth most commonly. More than likely, it is neuritis or a dropped third or fourth metatarsal heads.

When the metatarsals drop, this can rub the nerves that run in between the bones of the front of the foot making the nerves numb and causing the toes in front of the nerve, commonly the third and the fourth although it can happen in the second and the third or the fourth and the fifth become numb also.


By lifting the transverse arch, we will eliminate the excess pressure through the metatarsal heads that can be causing the pain. We also opened the joint space between the metatarsal heads to allow the nerves to flow freely once again.


If it is the case of Morton’s neuroma, this is a surgical case where the neuroma needs to be removed. Treatments are commonly cortisone injection if there is neuritis that is unbearable. There are side effects of this such as melting off the fatty padding which is actually very important for the area and the cortisone injection it should be the very last option.

Surgical removal is normally the first option with a real Morton’s neuroma and the most common and effective is an orthotic with the transverse arch lift that opens up the space between the metatarsals reducing the neuritis and also lifting the metatarsal heads to prevent extra pressure underneath the ball of the foot.

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What is Morton’s Neuroma?



There are quite a few different types of corn that can affect the feet.


1. There are shoe corns that develop on the top and side of the toes from shoes that are too tight.


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2. There are hard corns that develop underneath the foot from high pressure areas.


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3. There are soft corns that predominantly affect in between the toes from where the bones of the toes touch each other and cause a very painful soft corn that looks white and rubbery.


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4. There are seed corns that are genetic that are very very small and they look like they have been scattered across the sole of the feet and there are no bigger than the size of a pin head and actually very painful as they have in there is a touch to them.


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5. There are bio mechanical corns also that develop underneath the foot usually from a dropped bone or an enlarged bone inside the foot.


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So the podiatrist must first investigate what type of corn you have to advise what type of treatment will reduce or stop the corn from coming back.



When nail polish is applied it masks the nail and creates a waterproof covering. Water can get in from all edges of the nail polish and create a fungal infection underneath. Sweat from under skin goes through the toenail and gets trapped as the nail polish blocks the moisture from leaving the nail. This can rot the toenail. This can be avoided if you paint your nails and then remove the nail polish the next day try and think of it like putting on make up and taking off later that day.

Nail polish is much harsher than make up so the effects on the toenail are much more severe. The nail polish should really only be used for the special event or during the day or the evening and removed later. Nail polish that stays on for longer is thought to be of better quality. Of course nail polish can look very nice but hygienically it’s actually not the best for the nails.

By removing the nail polish the same day or the next day, it keeps the nails healthy and clean. Of course it’s nice to go for manicures and pedicures. Although everyone likes to keep the nail polish on for as long as possible it’s actually better to remove the next day. If the nails have been tidied and cleaned with a manicure and pedicure, it’s quite easy to paint the nail polish ourselves for a few times until the next professional manicure pedicure clean and tidy-up.

Happy and healthy nails are easily achieved with nail polish when used like make- up. Take it off as soon as you can and enjoy wearing it while it is on.



The new school year has started and fresh new school shoes are always a sign of new academic beginnings. However if you have noticed in previous years that the school shoes have become distorted in an unusual way it is a major sign of a foot problem.


The structure of the foot can distort a shoe causing unusual heel wear or unusual bulging on the upper leather part of the school shoe. When the shoe starts to deform, it can increase the problem in the structure of the foot. It is essential that you bring your child in for a foot assessment if you think their feet are moving in and unusual way or the shoe is wearing away and in unusual pattern.


You can make an appointment with a Podiatrist to check the alignment and in most cases it’s very easily corrected with a specialised orthotic inside the shoe that will align the fit and improve their walking and wear o the shoe.

Here is a photo of a shoe that has become worn away in an unusual heel area and also bulging inwards from a fit that is becoming flat. This boy was 14 years old and the problem was corrected with three phases of orthotic therapy in his school and sports shoes over nine months.

Click here to book online.

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The 2018 World Cup football has brought light on to the different types of football boots worn by different players.

Football boots can be made out of many different materials. For example, kangaroo skin can make the football boot very flexible in comparison to double strong cow leather hide which can make the football boot stiffer and give better support and protection during tackling.

A striker will want the football boots of extreme flexibility so that the slightest angle of their foot can show through the football boot when striking. The flexibility can help greatly with fast sprinting without any extra added effort that a thicker football boot will provide. A defender will want the thicker cow leather hide football boot style as they will need extra protection as they may be tackling harder to defend their goalkeeper and will want a stronger football boot instead of a super flexible soft football boot which will offer very little foot protection during tackles.



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A corn between the fourth and fifth toes can be very painful. It is often soft and quite large and can sometimes be white in colour. It occurs when the fourth metatarsal presses against the base of the first phalanx bone in the fifth toe. The excess pressure causes growth of a corn which underneath is actually an ulcer of the tissue.

To fix this corn we must address the boney alignment of the forefoot. A cast is taken of the foot and an orthotic must be worn inside the shoe at all times for minimum three months to align the metatarsals and the toe bones. Silicone to prop is also moulded to the shape of the fourth toe to give space between the fifth and the third toes also. An adhesive footcorns tape is also work for a month to hold the bones at the corrected position also.



Reducing pressure on the foot can be done using other areas of pressure load from the foot and also using the lower limb to take pressure away from the foot also. The more surface area that can contact a support device such as an orthotic or leg cast, the less impact on the wounded and ulcered area.

For example, if there is an ulcer underneath the foot an orthotic will reduce the pressure in that area let’s say by 5%. This is very good for off-loading an area with a corn. It will stop it growing back from the high intensity of weight in this particular area. If the pressure is too severe in a particular place then there will be a wound or an ulcer. In this case we need to use more skin surface area to reduce the stress on the overloaded area even further. This is when we would implement a total contact cast from the knee to the foot to reduce the pressure on the foot greatly.

We can imagine it like holding a vase if you hold a vase from underneath all the pressure is solely on the bottom of the vase. If you hold the vase at the sides like a total contact cast does on the sides of the shin and calf muscles then the pressure is greatly reduced when you place the vase on the table. Similarly if you hold the lower leg at the sides and front, the pressure on the foot is much reduced. That’s why we use the total contact cast to reduce the stress on the foot. A corn can be reduced by using an orthotic as this will reduce the load by 5%. A wound has to be reduced by minimum 30% pressure using below the knee cast or an air cast.

   


It is very common in babies and young children to have curling of the fourth toe towards the third toe. This is due to the way that the baby has been positioned in the womb. Not all babies have this condition because the big toe is usually the longest, followed by the second, third, fourth and fifth getting progressively smaller in length.

However, genetically some people have longer second, third toes and sometimes also quite long fourth toes. When the fourth toe is straightened from its curling position it is always the same length as the third toe. Normally the fourth toes is much shorter than the third toe. This causes the fourth toe to be curled when positioned in the womb under the third toe from the nature of the fetal position of the baby in the amniotic sac.



These toes are a result of a triathlon event. The toes show some bruising and one shows swelling and nail bed inflammation. The pressure from the liquid building up under the nail and unable to escape can cause severe pain to the toe, specially if there is any extra pressure added such as pressure from footwear or bed sheets.

The toenail needs removed and pressure release and another new healthy nail will grow.


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These little adidas children’s trainers are really helpful for parents. The insole that comes with this shoe has a helpful lined area. When the shoe is new the toes should touch the first line. This gives plenty of room for the foot to grow. It can be confusing trying to know what size to buy and how much room for growth to allow. This adidas children’s insole method is extremely helpful.


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