The Center for Podiatric Care and Sports Medicine

Standing-In for Dustin Hoffman Means Tired Tootsies

Posted by on Thursday, January 3rd, 2013

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When you have the word “stand” in your job title, you know you’re in for some tired feet. Stand-ins are the actors who replace the big name stars during prep time. As a stand-in actor for TV and film, Ben Hauck describes his job as “standing still for periods of time while crews set up lights and cameras around me before the principal actors step in.” Sometimes stand-ins are also extras so, when the standing is over, they get to do some more standing, this time in front of the cameras. Since actors can’t usually decide on their own footwear, stand-ins may have to suffer through movie star high-heel standing, pointy-toed cowboy boot standing, or barefoot standing, all of which increase their chances of developing a particularly prickly foot problem: Morton’s neuroma.

 

 

Morton’s neuroma isn’t quite as common as metatarsalgia (the subject of yesterday’s post), Achilles tendonitis, or plantar fasciitis but, since those are pretty well covered on this blog and elsewhere, I though Morton’s neuroma deserved a turn. It’s a condition that often puzzles sufferers, and it is caused by constant pressure (read: standing) alongside shoes that constrict the toes (like the kind you wear on a movie set). Actors beware!

 

 

A neuroma is thickened nerve tissue. It can develop anywhere on the body but a Morton’s neuroma, between the third and fourth toe, is the most common kind. It often presents as a lump in the ball of the foot. Some patients say it feels like their sock is bunched up in their shoe. Tingling and numbness are early warning signs, followed by pain that can be quite severe. Interestingly, people with bunions and hammertoes are more susceptible to developing a neuroma. Both of these conditions can result from pointy-toed shoes, high heels, and all-day standing. So, a seasoned stand-in actor may have occupation-related foot injuries that predispose her to developing a neuroma. It’s a vicious circle.

 

 

If you think you might be developing a Morton’s neuroma from long days on set, try the tried and true early home remedies as a first line of defense. If you can finagle wearing comfortable, supportive, wide-toed shoes, do that. Try to rest your foot as much as possible and apply ice. Padding and orthotics can also help.

 

 

If your pain doesn’t subside, it’s time to visit The Center for Podiatric Care and Sports Medicine (212.996.1900). In some cases, injections of corticosteroids can reduce pain and inflammation that doesn’t respond to over-the-counter anti-inflammatories. In severe cases, a podiatrist can treat the neuroma with surgery. There are two types:

  • Release surgery involves an incision on the top of the foot to relieve pressure on the metatarsal ligament, releasing pressure from the nerve. Since there is no incision on the bottom of the foot, you’ll be able to walk soon after the operation.
  • Removal surgery involves an incision through the bottom of the foot to remove the neuroma entirely. This surgery usually takes a bit longer to heal. You may need crutches for a while afterwards.
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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.