Preventing Morton’s Neuroma in Runners: What You Need to Know

Morton’s neuroma is a common issue among runners, especially those who increase mileage quickly or run in shoes that are too tight, narrow, or worn out. This condition occurs when a nerve between the toes—most often between the third and fourth toes—becomes irritated and thickened. Over time, it can lead to burning pain, tingling, or the sensation of having a pebble in your shoe.

The good news: with the right preventive strategies, most runners can reduce their risk and continue training comfortably. Here’s what you need to know.

What Is Morton’s Neuroma?

A Morton’s neuroma is a thickening of the tissue surrounding a digital nerve in the forefoot. Runners often develop it due to repetitive impact, improper footwear, or abnormal biomechanics.

• Burning pain in the ball of the foot
• Tingling or numbness in the toes
• Sharp pain during push-off
• A feeling of a marble or wrinkle under the toes

If untreated, symptoms can worsen and interfere with training.

Why Runners Are at Higher Risk

Running places repeated stress on the metatarsal heads—the bones at the front of the foot. Contributing factors include:

• High mileage or rapid training increases
• Narrow or tight running shoes
• High-heeled footwear worn outside of training
• Flat feet or high arches
• Forefoot-strike running patterns
• Restricted toe splay due to narrow toe boxes

Recognizing these factors is key to prevention.

Top Strategies to Prevent Morton’s Neuroma

1. Choose Proper Running Shoes

Select shoes that prioritize comfort and foot mechanics:

• Wide toe box for natural toe splay
• Good forefoot cushioning
• Neutral or stability support based on your foot type

Replace your shoes every 300–500 miles to avoid forefoot pressure from worn-out cushioning.

2. Use Metatarsal Pads

Metatarsal pads help spread the forefoot bones and reduce nerve irritation. They are useful if you have a narrow forefoot, feel early symptoms, or run long distances.

3. Strengthen Foot and Toe Muscles

Stronger foot muscles improve stability and reduce excess pressure on the nerve. Try:

• Toe splay exercises
• Marble pickups
• Short foot exercises
• Calf and Achilles stretching

4. Check Your Running Form

Forefoot or toe-strike running can overload the metatarsals. Consider:

• Shorter stride length
• Increasing cadence
• Avoiding excessive forward lean
• Working with a running coach or therapist for gait evaluation

5. Avoid Narrow or High-Heeled Everyday Shoes

Off-the-run footwear matters. Shoes that compress the forefoot contribute to nerve irritation. Choose wider, supportive options whenever possible.

6. Build Mileage Gradually

Follow the 10% rule when increasing mileage or intensity. Supplement with cross-training to reduce repetitive stress on the forefoot.

When to See a Specialist

If you experience burning, tingling, or persistent pain in the ball of your foot, early evaluation is essential. A foot and ankle specialist may recommend:

• Imaging for diagnosis
• Custom orthotics
• Targeted therapies such as injections
• Gait analysis or footwear guidance

Early treatment helps prevent progression and keeps you running comfortably.

Final Thoughts

Morton’s neuroma is preventable for most runners. With proper footwear, strengthening, and gradual training progression, you can protect your feet and continue enjoying your runs. If symptoms appear, don’t wait—early care can make all the difference.