Here is a real email I recently received from a patient in another state who reached out to me because his doctor want to operate on him even though he admits he does not know what is causing the patients symptoms.  But before you read the email take a minute and read the below paragraph as it pertains to why the patient is not getting expert care….in fact it explains why you too may not get expert care.

I fix foot conditions for patients regularly in San Diego.  I also am able to help patients from around the world with conditions such as Morton’s Neuroma, Metatarsalgia, Plantar Plate Tears, Bone Marrow Edema and Capsulitis. One of the reasons for this is I have been treating these conditions 20-30 times a week for over 10 years.  They say practice makes perfect.  In fact research supports that what separates “Masters” from “Novices” is practice, and lots of it.  It is widely believed that 10,000 hours (a general number to be sure) is what gives an expert the ability to consider the entire spectrum of possibilities and weed out the information that matters from the nonsense that does not matter http://www.wisdomgroup.com/blog/10000-hours-of-practice/. So doctors that dabble in treating these foot injuries simply do not have the practice to make them an expert and that is unfortunate for many patients with these chronic and painful foot conditions. They simply do not have the ability to zone in on what is important and weed out the unimportant which allows you to arrive at an accurate diagnosis.  In order to have effective treatment and accurate diagnosis is necessary.  The other variable is the ability to learn, synthesize information and begin to see patterns.  Through experience and the desire to get better we use our experiences to get better the next time we find ourselves in a similar situation.  This is what separates the Tom Brady’s and Peyton Manning’s of the world from average quarterbacks.  Not only did they practice 10,000 hours or more but they wanted to be better, in fact, they wanted to be the best so they practiced, synthesized and learned allowing them to become an expert.  Doctors are no different by the way.  That is why they call it being in “Practice”.  The difference is not all doctors are Tom Brady or Peyton Manning.  Instead they are average or sub-par and don’t care to synthesize, learn and become an expert.  I do.

Hello Dr. Allen,

I have bilateral metatarsalgia, with my left foot having more serious issues. I was a runner for several years, but have not been walking or running for exercise in a long time. My orthopedic surgeon believes my left foot does not have Morton’s neuroma, but has not conclusively identified a reason for my chronic symptoms. He has recommended a gastrocnemius lengthening, but I am not so hot on that.

I live in Illinois, so it is difficult for me to come to San Diego. I hope you could recommend a colleague in the Midwest, perhaps in the Chicago area.

Thank you,

“Met Pain in the Midwest”

My Response:

Hi Met Pain

I am sorry you are suffering from this.  Has your surgeon done an MRI.  If so send me the report.  Surgery to lengthen the gastroc does not sound like a good idea…….especially considering the fact that as you stated “He has not conclusively identified a reason for my chronic symptoms”.  I supplied you with some good information below and will also give you a link to one of my arcticles explaining the difference in various metatarsal conditions https://www.sdri.net/injuries/lower-body-injuries/metatarsalgia/

You could  have;

  1. Mortons Neuroma ( do you have “burning” into your toes)
  2. Plantar Plate Sprain/Tear (most likely diagnosis.  This is a severe sprain common in runners)
  3. Capsulitis (might be secondary to Plantar plate tear)
  4. Metatarsalgia (it is possible you have bone marrow edema in your metatarsals)
  5. Stress Fracture ( possible to be a stress fracture AND