Is “Fibromyalgia” Actually Morton’s Foot Syndrome? - by admin@mcb on October 09 2017

Is “Fibromyalgia” Actually Morton’s Foot Syndrome?

The Fibromyalgia-Morton’s Foot Connection

Fibromyalgia syndrome is often present in people who have a condition known as Morton’s Foot Syndrome (sometimes called Morton’s Toe). Fibromyalgia is sometimes a bit of a “catch all” diagnosis for multiple areas of pain in the soft tissue. There are 18 pain points used in the diagnosis. What is little known and not well understood is that often the source of pain can actually be an abnormal bone structure of the foot called Morton’s Foot Syndrome.

What is Fibromyalgia?

“Fibro” mean fibrous tissue (connective tissue such as tendons and ligaments), “My” means muscles, “Algia” means pain. Therefore, fibromyalgia means pain in the muscles and connective tissues of the body.

What is Morton’s Foot Syndrome?

Morton’s Foot Structure (also known as Morton’s Foot Syndrome and Morton’s Toe) is a hereditary condition characterized by either 1) excessive mobility of the first metatarsal bone, or 2) a short first metatarsal bone in comparison to the second metatarsal bone.

This foot structure results in less stability and improper weight bearing action of the foot. With each step, the overly mobile or overly short first metatarsal tends to give way, forcing more weight to be put onto the second metatarsal. The foot attempts to compensate by hyperpronating or dropping the arch. The body compensates with an inward rotation of the lower leg, and to compensate for that, an external rotation at the hip joint. Every joint is bearing weight in an awkwardly rotated position, which causes every muscle attached to those joints to be lengthened or shortened in the process, creating a series of trigger points in the muscles.

When a foundation is unbalanced, the entire structure is unbalanced, so the pain goes from head-to-toe. Seemingly unrelated conditions such as jaw pain are often side effects of Morton’s Foot Syndrome.

Morton’s Foot and Myofascial Pain

The leading physician behind most of our current understanding on trigger points and myofascial pain, Dr. Janet Travell, determined that as much as 80% of all myofascial pain (not just in fibromyalgia) is caused by Morton’s Foot Syndrome.

Among my fibromyalgia patients, I am finding that nearly all of them actually have Morton’s Foot Syndrome, and when the foot condition and the muscle imbalances it caused is addressed, the “fibromyalgia” suddenly gets much better.

To Learn More

To learn more about Fibromyalgia and Morton’s Foot, Institute of Somatic Therapy offers two online continuing education courses for massage therapists. Institute of Somatic Therapy is approved by the NCBTMB as a continuing education Approved Provider #280672-00.

For details on these courses, click the links below:
Fibromyalgia – Stop the Suffering
Morton’s Foot Structure
Complete List of Our Courses

# # #

Institute of Somatic Therapy  www.massagecredits.com

“Committed to Excellence in Continuing Education”

The Institute of Somatic Therapy is committed to providing the best online home study continuing education courses available to massage therapists. Institute of Somatic Therapy is approved by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) as a continuing education Approved Provider. Provider # 280672-00. Our massage CEUs/credits are also valid for AMTA and ABMP. We are approved by the Florida Board of Massage (Provider #MCE326), the Georgia Board of Massage, the New York State Board for Massage Therapy (#0019), and CE Broker (Provider #50-1116). Our massage therapy continuing education courses are valid for most state massage therapy CEU requirements.

Morton’s Toe/Plantar Fasciitis - by admin@mcb on March 28 2017

Morton’s Toe/Plantar Fasciitis

Morton’s Foot Syndrome (commonly called “Morton’s Toe) is a condition where the first metatarsal is shorter than the second metatarsal. In a normal foot, both the first and second metatarsals are of the same length. Plantar Fasciitis is a condition where there is an inflammation of the plantar fascia, a thick band of connection tissue that joins the heel bone to the toes.

The Mechanics of a Normal Stride

With each step we take, our feet alternately push off the ground. For a fraction of a second, the first metatarsal bears the weight of the entire body. As the foot rolls forward, some of the pressure is shifted to the remaining foot bones.

Altered Mechanics of a Morton’s Toe Stride

For people who have Morton’s toe, the first metatarsal is shorter than the second, rolling the weight to the second metatarsal. This second metatarsal bone wasn’t designed for that amount of pressure. To compensate, the foot overpronates (rolls in the direction of the big toe) to recruit support to hold the excess weight.

As a result, the foot is momentarily unstable. This causes a chain reaction in the body, as other muscles and joints shift from their designed movement pattern to compensate for the instability. In the process, the plantar fascia experiences stress and damage which can lead to the painful condition of plantar fasciitis.

Pain from Morton’s Toe/Plantar Fasciitis

The overpronation can lead to pain in the ankle, knees, and hips. Muscles all along the leg form trigger points and myofascial pain. It has been estimated that as much as 80% of all myofascial pain is a direct result of Morton’s Foot Syndrome. (Source: Myofascial Pain and Dysfunction: The Trigger Point Manual, by Janet G. Travell, M.D. and David G. Simons, M.D.)

Massage for Morton’s Toe/Plantar Fasciitis

Massage therapists should assess their clients’ feet for  the classic signs of Morton’s Toe (a long second toe and/or hypermobility between the first and second metatarsal bones). When found, they need a two-pronged approach to treatment: educating their client how to mitigate the impact of the bone abnormality through the use of orthotics, and treating the trigger points and muscle abnormalities that have developed from the abnormal gait.

Massage CE Courses for Morton’s Toe and Plantar Fasciitis

Institute of Somatic Therapy offers two pathology courses that address foot pain. Both courses are valid for CEs for NCBTMB, Florida, Georgia, and most states.

Click below for details:

Morton’s Foot Syndrome

Plantar Fasciitis

Morton’s Foot and Myofascial Pain - by admin@mcb on June 01 2016

Morton’s Foot and Myofascial Pain

According to Dr. Janet G. Travell, the originator of Trigger Point theory, Morton’s Foot (also called Morton’s Toe, after Dr. Dudley Morton) is the cause for approximately 80% of patients who exhibit chronic musculoskeletal pain.

Morton’s Foot Structure – What Is It?

In a normal foot, the first and second metatarsal bones are the same length. Ideally, the first metatarsal should meet the ground before the lesser metatarsal bones, and the first metatarsal is designed to carry double the weight as the second metatarsal bone. With Morton’s Foot Structure, the second metatarsal bone is longer than the first, so it meets the ground before the first metatarsal bone. Instead of the way a normal foot would distribute the weight approximately 66% on the first metatarsal and 33% on the second, the second bone is now forced to bear nearly 100% of the weight, and leads to excessive pronation of the foot with each step. This pronation in turn has a negative chain reaction link on every joint in the walking process (ankle, knee, and hip).

Source of Pain

In a normal foot, the foot pronates momentarily as the arch flattens and rolls toward the ground. As soon as the foot meets the ground, it will begin to supinate slightly as it stabilizes against the surface, so the body is supported as the foot pushes off on the next step.

In a Morton’s Foot, the supination is delayed. The hypermobile first metatarsal bone does not reach this point of stability, and the rest of the foot attempts to compensate with irregular movements. The body’s weight is not properly distributed across the five metatarsal bones. Instead, the second metatarsal bone ends up bearing nearly 100% of the body’s weight.

Effects of Morton’s Foot Structure

The pain caused by Morton’s Foot Structure goes far beyond foot pain. Dr. Travell observed that Morton’s Foot Structure was a significant cause of myofascial pain to the “low back, thigh, knee, leg, and dorsum of the foot”.

Some of the many other conditions thought to be associated to Morton’s Foot Structure include fibromyalgia, night cramps, restless leg syndrome, stress fractures of the lesser metatarsal bones, heel spurs, osteoarthritis, and meniscus tears.

Treating a Client with Morton’s Foot Syndrome

When you have a client that shows the symptoms and effects of Morton’s Foot Structure, you should assess each muscle in the lower extremity to determine the presence of trigger points or other types of dysfunction. But working to release trigger point and myofascial dysfunction is useless without also instructing your client how to balance out the foot with the use of a compensating pad, to prevent the source of the dysfunction you are working to release.

For specific instruction on using a compensating foot pad properly, refer to the works of Dr. Travell or Dr. Burton S. Schuler (Author of Why You Really Hurt: It All Starts in the Foot). The Institute of Somatic Therapy also offers a 3 CE massage therapy online continuing education course title Pathology – Morton Foot Structure designed to show massage therapists how to bring relief to their clients with Morton’s Foot.