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High Heels Fuel Foot Pain for Female Runners

Runners often cite the wide array of health benefits—physical, mental and emotional—as their motivation to keep logging the miles. But like any strenuous physical activity, running can also lead to overuse injuries. One of those injuries affecting women in particular is a foot pain so intense that it prevents them from running at all—the painful neuroma.

Foot and ankle surgeons at the Annual Scientific Conference of the American College of Foot and Ankle Surgeons (ACFAS) in Orlando this week are evaluating how to effectively treat neuromas, a too-common foot condition among women. Research has found that female runners are often plagued by intense foot pain caused by an unassuming culprit: fashion. Women tend to wear fashionable shoes that are narrow with pointed-toes only to then pound those squished, weary feet into the pavement on training runs. This pattern sets women up for a neuroma, a serious nerve disorder of the feet.

According to Scottsdale foot and ankle surgeon and conference presenter Kris DiNucci DPM, FACFAS, active women who enjoy running are prone to neuromas, especially if they regularly wear narrow shoes and have flat feet. A neuroma occurs when a nerve located between the toes becomes enlarged and inflamed and produces tingling, burning pain. Dr. DiNucci, who is a Fellow member of the American College of Foot and Ankle Surgeons, says the symptoms begin gradually and, left untreated, progressively worsen. Patients often complain that neuroma pain feels as if something is stuck inside the ball of the foot. Relief for the symptoms may come by massaging the foot, wearing wider everyday shoes with low heels and avoiding running and other activities that aggravate the condition.

The most common occurrence is called Morton's neuroma, which develops at the base of the third and fourth toes. Treatment options depend on how far the condition has progressed. At early stages, padding lessens pressure on the nerve, icing reduces swelling and over-the-counter anti-inflammatory medications or injection therapy decreases pain and inflammation. Prescription or custom orthotic devices provide support to reduce traction and stress to the nerve. Patients are advised to wear wider shoes with low heels and to take a break from running or other aggravating activities until the condition improves. In severe cases, surgery might be the best option to provide relief. A foot and ankle surgeon can release or remove the affected nerve with an outpatient procedure.

Dr. DiNucci stresses, "The key to success is early treatment. Correcting training errors with changing the running surface, switching shoes, adding supportive inserts or using prescription orthotics can be the difference between a short course of treatment and surgery." Whatever the prescribed treatment, a neuroma diagnosis means a disruption in schedule for the runner. And depending on the nerve's response to treatment and the time it takes for healing, a neuroma can thwart activity for long stretches.

"Over the past few years," Dr. DiNucci explains, "there have been many advances improving the outcomes of foot and ankle surgery. In the treatment of interdigital neuromas, many new techniques have been developed from in-office procedures to minimally invasive techniques to allow our patients to return to their running pain-free in the shortest timeframe." For women who have found running gives them the best health benefits, that's good news. Although their fashion may need adjusting, most women would agree that a return to regular-and pain free-running is better than being a fashionista.