Physio webchat with Paul Hobrough

Catch up on our webchat for expert advise from Paul Hobrough.

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Q. I've been diagnosed with a Morton's Neuroma, whats the best way of dealing with this, is it worthwhile paying for special insoles, would a change of shoe help, currently run in Brooks Adrenalin as I'm an overpronator, not sure if something like Hokas would help. I want to be able to run another marathon and just don't think my foot would let me at the moment. - hondawins2

A. Thanks for this question and please do read my response to the foot pain experienced by Sara fen cot. However you ask some very specific questions about orthotics and Hoka shoes which I would like to address.

Firstly orthotics are excellent in many cases, I do think that at times they are simply, "a change is a good as a rest" and I actually prescribe orthotics so I am doing myself an injustice as it is far more complicated than this, however take the sentiment that they are not a panacea treatment for all things foot and ankle!!

When you get pain in your foot and ankle, there is a reason for this, and biomechanics play a large role in this, but do we just shove something under the foot to make it "normal"? and what is "normal"????  sorry to be a little Philosophical but there is not ever going to be a 'normal' foot (see my points on asymmetry earlier)

For a mortons neuroma, you need to prevent the bones in the foot (metatarsals) from becoming bound tightly together.  In the right shoe an orthotic can do this very successfully, but in the wrong shoe, it makes the shoe tighter… so the mechanics that perhaps started the issue are corrected but there is now a huge stimulus that keeps the symptoms aggravated and thus nothing gets better.

You also mention Hoka shoes, these are very cushioned 'ultra runner' style shoes and I have a few clients with foot and ankle issues that swear by them.  I don't know enough to fully endorse them but when i have had a chance to try them myself I can have a more informed opinion.

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