In the last 2 blog posts, I explored treatments for Morton’s neuroma. I concluded last week with components for a good orthotic device for your patient. The balancing of the device should be based on the patient's individual mechanical needs, like forefoot to rearfoot balancing or pronation and supination corrections. Once we establish how we want to control the foot, we can get down to the modifications for our neuroma symptoms.
KevinRoot Medical offers a P9 Neuroma orthosis for you to look at also. I like the intrinsic posting suggestion to avoid pitching patients forward, but have never used the neuroma pad as outlined. This may be a great dress shoe device.
Morton’s Neuroma Orthosis Design
- Balancing for individual biomechanical needs (typically B, P, or S orthoses) with emphasis on lifting metatarsals dorsally. You can balance forefoot deformities, metatarsal arch, or both.
- When you put on an extrinsic rearfoot post, have the contact point thinned to 1 mm or less before post application.
- Place a 1.5 mm neutral metatarsal bar at distal edge of plastic or leave that distal edge full thickness in area of neuroma
- Glue heel area only of the top cover so that you can experiment with the position of the metatarsal pad
- Add 3 mm Myolite layer full (athletic) or sulcus (dress)
- Under the Myolite layer place an equal length slot accommodation to off load the sore metatarsals
