PJ in MA: Can you tell me your opinion on the use of Vibram toe shoes as a tool to strengthen the metatarsal area? I'm 65, and my wife and I love to dance. I've had a Morton's neuroma diagnosis in both feet, and it continues to be unresponsive to cortisone shots. There is some concern that it may be metatarsalgia and would benefit from general foot muscle strengthening. I wear larger toe-box footwear with orthotic inserts and get great relief, but not enough to enjoy pain-free dancing or fast walking. I use the elliptical machine at the YMCA as an alternate regular exercise. I very much appreciate your input.
Dr. Zinkin: Metatarsalgia might probably be a more accurate diagnosis in a dancer, since the stress and strain on the forefoot is great while whipping around the dance floor. I do not believe that the Vibram shoe will help and in this case, and it might actually hinder the healing process. Your feet will benefit more by wearing the orthotics with a good running sneaker or supportive shoe as much as possible. It is also possible to have your podiatric physician make a pair of thin orthotics made specifically for your dancing shoes—that should help somewhat. In any case, make sure that you do not walk barefoot or without shoes in the house. This can also cause the metatarsal pain to worsen. Of course, there is always rest. If you and your wife can do some swimming for a few weeks, that might also allow healing. Good luck!