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Equines, Tarsal tunnel and things that go bump in the boot

post #1 of 8
Thread Starter 
I recently consulted a highly recommended podiatric surgeon regarding my Morton's neuromas.  Mine are not only bilateral, they have been surgically treated once, 30 years ago, with poor outcome.  Furthermore, when I considered what it was I was doing for relief when I was stopping to remove my left boot mid morning, I realized that I had developed a new lesion in the left 2-3 metatarsal space to match the more common ones in both 3-4 spaces.

I was actually hoping this man, who had performed a surgical miracle cure for my friend, would whip out his scalpel, shuck these missed, new, or stump neuromas out and have me cured for the 2012/13 ski season.  Instead, while he confirmed my assessment of the situation, he began a course of alcohol injections. While I must admit I love the idea of avoiding the knife if at all possible, this meant seven weeks of (painful) injections, followed by a three month assessment interval and then, potentially, surgery.  By this time, not only might we have moved away from the area (and his highly recommended skills), but it will be September and only two months will remain for recovery before ski season!

He also diagnosed equinus (I knew I had "a rigid foot") and said I had a tarsal tunnel entrapment: something I had self diagnosed some time ago, so, a nice ego boost.  Unfortunately, his only answer to my question about its impact on my activities was, "It will probably only bother you in a ski boot."  Well!  Okay!  That's why I was there: to get my feet in shape for my upcoming purchase of new ski boots and the next ski season(s)!   

What can you tell me about tarsal tunnel syndrome, equinus, or even Morton's neuromas that might guide my purchase of new boots this fall?  I am currently in a 6 or 7 year old Salomon (customized by Jack Rafferty in Snowmass). They have served me well, but it is definitely time: I delayed the purchase of new boots since I was told they would be more fully customizeable this year than last.  I clearly waited a season too long: I have callouses on the outsides of my heels from riding up and down in the back of the boot those last few weeks!  I have the predictable wide feet and, in my mid 60's, have evidently lost some of my historically high arch as I have had a problem with plantar fasciitis over the last two years.  Yes, I ski with custom orthotics and have them in my shoes as well.

If you have any guidance to offer that would steer me to an excellent boot fitter in the Big Sky (Montana) area, that would also be very welcome. One hears of so many superb ones - or meets them, Jack Rafferty, in my case - but I suspect that leaving my home mountain for boot fitting would be an error of the greatest magnitude.
post #2 of 8

A little confused.  Jack isn't in Montana and you used him before.  Why not go back?


Anyway I ski big Sky each spring and I'm unaware of anyone in Montana that is really knowledgeable.  There are other guys here that can provide more help specifically with your problems than me but with regards to your Morton's neuroma that problem is one of putting your forefoot in to narrow a space and the compression  across your metatarsal heads irritates the nerves passing in the space between each pair of heads.  I most often see it between 3 and 4.  The solution there is to make certain the forefoot is wide enough to let your foot lay flat and relaxed.  It can be accomplished by purchasing a wide boot or if the overall volume will then be to much purchase a narrower boot and have the forefoot widened.



post #3 of 8
Thread Starter 
Thank you for your prompt reply. Unfortunately, as the owner of several (and a PA) I am only too familiar with the care and feeding of Morton's neuromas! I have never owned a pair of ski boots without the familiar 'sixth toe' bubbles - after purchasing ones with roomy toe boxes to begin with.The abuse occurred much earlier, I imagine, during years of wearing high heels and other abusive footwear. Now I am saddled with a problem that sometimes causes problems even in the most auspicious of footwear.

Regarding returning to Jack Rafferty: he is indeed in Snowmass. I was privileged to have him work with me before we bought in Big Sky, when we were taking annual trips. But, if I recall correctly, one of the tenets of the boot fitters site states to get your boots close to home in order to facilitate "tweaking". This leaves me in a quandary inasmuch as you know of no one of quality in Montana. Perhaps a trip to SLC? At least I would have season pass reciprocity at Brighton for that purpose.
post #4 of 8

Well I agree with you on the tenents, but it seems impossible to follow in your case so I simply thought Jack could help again.  If you are going to SLC see Steve Bagley in Snowbird.  When you are in Big Sky again, the guys in the mountain shop (don't remember the name but tuning and repair centre downstairs and retail up) know how to punch.  They aren't much on overall biomechanics but may be able to help with simple punching.  Or fly to Bozeman through Calgary and I'll help.



post #5 of 8

Are you using a foot orthotic with met pads?



post #6 of 8
Thread Starter 

 I think you're talking about Lone Mountain Sports in Big Sky, Lou, they fit your description. We have bought quite a bit there, including boots for my husband's "out of the box" feet.  They have some Masterfit University classes under their belts. I have met pad in the right orthotic - the foot with the terrible neuromas - not certain about the left. Heel lifts which may help with the equinus.  Daily stretches, of course. I pay if I don't do them but don't see a lot of progressive improvement with them.


Although we drive, rather than fly, Calgary is definitely on our bucket list and we would love to come, so I may show up on your doorstep! Thank you so much for that offer, Lou.


post #7 of 8

You're right it is Lone Mountain Sports.  The heel lift will help with equinus and if it is only one foot you might consider binding or external boot lifts on the other side to level you out again.


If you come this way watch conditions and come to ski Fernie or Louise in the spring after a good winter.  both are very different from Big Sky.



post #8 of 8

You might contact RicB by PM. While he is not a professional boot fitter, he is a ski instructor who has a special interest in boot fitting and may be able to offer some guidance. 

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