Myofascial Pain and the Morton’s Toe
A great deal of the information about Myofascial Pain Syndrome that follows came mostly from Dr. Janet Travell and Dr. David G. Simons, two-volume set of books called Myofascial Pain and Dysfunction: the Trigger Point Manual. These books are acknowledged as the most important books ever written on this subject.
What is Myofascial Pain Syndrome?
Myofascial Pain Syndrome involves chronic muscle pains. It can affect single muscles or groups of muscles. The locations on the muscles where these pains take place are called trigger points. Myofascial Pain Syndrome can also cause pain away from these painful muscles. This pain is called “referred pain.” Dr. Janet Travell wrote that Myofascial Pain Syndrome could also cause tenderness, muscle spasms, limitation of motion, depression, sleep disturbance and changes in circulation
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What Causes Myofascial Pain?
Besides Morton’s Toe, there are several other causes of Myofascial Pain Syndrome including:
1. Mechanical stress, muscles that are just not working properly,
2. Postural stresses, due to poor posture or sitting abnormally in bad chairs or desks,
3. Constriction of muscles, due to tight stockings or a bag strap put over your shoulder for too long a time.
Myofascial Pain Syndrome can also be caused by leg length discrepancies (one leg shorter than the other), vitamin deficiencies, slow metabolism, low blood sugar, depression, anxiety infections, and sleep disorders.
Morton’s Toe and Myofascial Pain Syndrome
In her biography, Office Hours Day and Night, Dr. Travell states how she was aware early in her career that when the second metatarsal bone was longer than the first metatarsal bone (Morton’s Toe), it could transmit abnormal mechanical stress to the muscles of the ankle, knee, and hip joints that could result in pain in these areas.
How Morton’s Toe Causes Myofascial Pain
In volume 2 of Myofascial Pain & Dysfunction: The Trigger Point Manual, Drs. Travell and Simons wrote a great deal about the “Dudley J. Morton’s Foot” (Morton’s Toe ) and its relationship with Myofascial Pain Syndrome. They show how if you have a Morton’s Toe, your foot is not working right. This will cause many muscles to be stressed and injured. According to them there are six muscles that can be activated or have “trigger points” due to the “Dudley Morton Foot”. The amount of pain, and suffering that can be caused by these six muscles is astounding. Here are the six muscles that can be caused by Morton’s Toe and the pains they can cause:
· Gluteus Medius : this muscle can cause lower back pain (lumbago), pain at the back and side of the buttock, and into the upper thigh.
· Gluteus Minimus Muscle: the pain from this muscle can extend from the buttock down the thigh, knee, leg, calf and ankle. Other doctors have suggested that sciatic pain can be caused by this muscle.
· Vastus Medialis Muscle: trigger points from this muscle can cause a referred pain on the front of the knee, and the lower thigh.
· Peroneus Longus Muscle : referred pain from this muscle cause pain on the outside of the ankle and area on the outside of the foot.
· Posterior Tibial Muscle: the pains caused by this muscle start at the mid calf, go over the Achilles tendon, over the heel and can cover the entire bottom of the foot and toes.
· Flexor Digitorum Longus Muscle: this causes pain mostly to the bottom of the middle of the fore foot.
The bottom line is that pains of your back, thigh, knee, calf, leg, and (of course) your ankles and feet can be due to Myofascial Pain, which in turn can be caused by having a Morton’s Toe, or the “Dudley J. Morton’s Foot.” It can also cause Temporomandibular Joint Pain, or “TMJ,” which can make your teeth, jaw, cheek, eyes, eyebrows, and ears hurt. It can even cause headaches. According to Dr. Travell, “TMJ” is a form of Myofascial Pain.
The Videotapes
In 1990, Dr. Travell made a series of seven videotapes to educate health professionals about Myofascial Pain Syndrome. The tapes showed how to identify and treat those painful muscles throughout the body, most often affected by Myofascial Pain. Of the seven tapes, only one was dedicated to a single subject. That tape was called “The Dudley J. Morton Foot “(Long Second Metatarsal). Its purpose was to educate her fellow physicians of the important role the Morton’s Toe can play in regards to causing pain throughout the whole body.
It is hard to believe that Janet Travell was eighty-nine years old when she made this videotape. In it, you see a highly intelligent and articulate physician, delivering a lecture with an incredible ease and command of the facts concerning “The Dudley Morton Foot,” and all the problems it can cause. To watch her hands, the same hands that treated two Presidents of the United States, craft her version of the pad to treat Morton’s Toe are truly remarkable.
Like many other physicians, I believe Myofascial Pain Syndrome, and Fibromyalgia are very similar to one another. In my office I refer to them as being “first cousins.” They are both painful disorders of the muscles that make millions of lives miserable. They are so alike that medical textbooks have already been written about both of them. Medical journals have also been written about their similarities. This is important because if you understand how a Morton’s Toe can cause Myofascial Pain Syndrome, then you can understand how a Morton’s Toe can also cause or be part of the cause of why you may get fibromyalgia. To the best of my knowledge, no doctor has ever made that statement before. I treat many women who have already been diagnosed with fibromyalgia. Many of them do have a Morton’s Toe. Like those with Myofascial Pain Syndrome many of these women with “Fibro” get better by applying a toe pad to their first metatarsal bone. If you have been diagnosed with Fibromyalgia, slowly try the toe pad to see if it helps. But be warned! The Toe Pad is very dynamic and in fact can make someone with fibromyalgia worse.
So the best thing to do is to try the Toe Pad only for about one or two hours a day for a week. If that feels good, then gradually add one hour every week, until your body gets used to the Toe Pad. Stop using the Toe Pad at once if it is hurting you. Regardless, the Toe Pad is not intended to cure Fibromyalgia. Its job is to stabilize the Morton’s Toe so your “Fibro” will not get worse. I write more about Myofascial Pain Syndrome, and Fibromyalgia throughout Why You Really Hurt: It All Starts In The Foot.
