4. Selecting cycling shoes with a wider toe box or adjustable strap tension in the forefoot area.
5. Adding a metatarsal pad or bar on the top of shoe insole. The position of the pad should be placed behind the MTP joints (Ideally, this should be done with the guidance of a qualified orthotist to ensure proper placement of the pad).
6. Tilting the inner forefoot with a shim that is placed under or on top the shoe insole.
You can also reduce nerve inflammation by taking oral or applying topical anti-inflammatory medications such as Ibuprofen.
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If symptoms persist despite taking the above measures, a corticosteroid injection of the neuroma could be considered. If corticosteroid injections fail or stop working after several have been attempted, surgical excision of the neuroma (neurotomy) could also be considered for treatment. This usually results in some permanent numbness of the affected toes, but not paralysis.
Other possible causes of forefoot pain in cyclists include large toe MTP joint bunions (hallux valgus), osteoarthritis, hammer toes and metatarsal stress fractures. A medical physician should be consulted to ensure proper diagnosis and management of severe foot pain from cycling.
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Common Sports Injuries: