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Bumpy Ride: Saddle Bone Deformity

Posted by on Wednesday, August 1st, 2012

Sure, you may think you know everything about bumps on your foot because you read about ganglion cysts, those squishy lumps that can grow on the top of your foot. How about this, though–what if that bump on the top of your foot is hard and bony?

Okay, you got me–what if that bump on the top of my foot is hard and boney? Then you, my friend, most likely have a saddle bone deformity. Or as we fancy anatomical types call it, a “metatarsal cuneiform exostosis.”

I like the first name better. I thought you would, but the official name helps us understand where this is all happening. The metatarsals are the long bones of the foot that connect to our toes. The metatarsal cuneiform joints are the three joints at the base of the metatarsals at midfoot. An exostosis is a bony growth. So we’re talking about a bony growth at midfoot, right about at the bottom of a metatarsal bone.

Where does the saddle bone part come in? If your foot was a horse and you wanted to put a saddle on it so a tiny elf could ride your foot on a mystical night lit by a crazy full moon, you’d put the saddle right about where your metatarsal cuneiform joint is located. At least that’s my story. It’s more like the saddle bone deformity  is at the peak of the arch of your foot, “saddling it.”

So why would I have a bony growth there? A saddle bone deformity can occur for a number of reasons. People with high arches may be prone to them. Poor foot mechanics can cause the bone to grow. An injury in the area may lead to a saddle bone deformity. If the metatarsal cuneiform joint moves around too much, bone may grow in order to stop the excess movement.

Is it bad, other than being weird and ugly? No, a saddle bone deformity isn’t a serious condition. It just causes problems when you put a shoe on and have to deal with a bump. They may also press down on the peroneal nerve, which will add pain.

How do I know I have a saddle bone deformity? Well, you’ll see a bump on the top of your midfoot that feels hard and bony if you touch it. It probably won’t hurt if you don’t have shoes on or wear open shoes like flip flops. If you do have full cover shoes on or sandals with straps that come across midfoot, you’ll feel pain and irritation on the lump.

You can find out whether your saddle bone deformity is pressing on your peroneal nerve by testing for a Tinel’s sign. Just tap the bump with your thumb and index finger; if you feel tingling, then the saddle bone deformity is pressing on your nerve.

Of course it’s always best to see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) to get a full diagnosis and make sure the bump isn’t anything else.

So what do I do about this deformity? In most cases, a podiatrist  would recommend conservative treatment: choose shoes that don’t rub or irritate the bump, put padding into shoes that would be a problem. If the problem is poor foot mechanics, a podiatrist may recommend physical therapy to help correct your gait problem.

If, however, the saddle bone deformity is causing you a great deal of pain, a podiatrist may recommend surgery to remove the bony outgrowth. This is a relatively simple procedure that usually takes no more than an hour, and you’ll be able to put weight on that foot immediately, unlike most foot surgeries. Of course you won’t be instantly healed–it will take about four to six weeks for you to return to your full level of activity.

All in all, that’s not so bad, though. No one likes to have a deformity of any kind, let alone something that sounds like it should be associated with horses and stables more than feet. However, it’s likely that you’ll be fine, whether you choose to have the outgrowth removed or just want to live with it.

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine LaiDr. Nadia Levy, and Dr. Ryan Minara 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.

8 Responses to “Bumpy Ride: Saddle Bone Deformity”

  1. Ashia says:

    Cool. Now I know the name of my bump. It’s small, so I only notice it when I am doing yoga (position: on knees, place hands behind ankles – on the side, lean head back – looking up). My body presses down on the bone and it can be uncomfortable if I’m not in the correct form.

    Also, I had a non-painful small cyst on my wrist for a few months(thought I had cancer or something, lol) and my sister had a that type of ganglion cyst when she was younger, very painful.

  2. Gladys King says:

    Just got back from Dr.s concerning my feet. Will have x-ray to determine for sure. I thought why not check with internet to see if I could find the problem. Went to the Dr. years back and she said arthritis, but is getting worse. Saw this and I know this is it. I have this on both feet. So glad I came upon this site. The picture looks exactly like the top of my feet! Thanks so much for your help!

  3. Mark says:

    I am reading about this and I am sure this is what my outgrowth is. I have the tingling in my toes but no pain to mention. I think this developed when I had a pinched nerve in my back. I had some numbness in my shins and feet for a few months. I think that the the compensation for normal movement in my foot took its toll. Is it dangerous to leave that tingling go in the toes. Will it eventually kill the nerve completely?

  4. Clare says:

    Thanks so much for the pictures. Have been suffering with this pain for over 6 years now and my foot looks just like that although mine’s on the left!

    Went to a podiatrist a while back and got treated for bursitis in between the big and second toes which seemed to help the pain – but I think it was just masking the real issue…

    Now at least I will have some information for the podiatrist when I go in a few weeks.

    Very grateful to you :)

  5. Matt says:

    So happy I came across this, its exactly what I have, I’ll have to go to the doctor to see what can be done. I gave myself a sharp pain in my foot playin softball last year and could barely walk on my foot and went to the emergency and the doctor brushed it off as a cyst and told me it will go away. It never did and I feel deep nerve pain in that exact spot when i sometimes press off that foot, glad i finally know what this is! Thanks for the great info

  6. Norah says:

    Thanks for the info! I have a saddle bone on both feet and I got the larger one (on my right foot), shaved down about 10 years ago, but the doctor wasn’t able to remove it completely. Six months later, I developed a stress fracture in my second metatarsal, which healed nicely after 6 weeks in a boot. Unfortunately, the stress fracture has returned 10 years later and did not heal completely after 6 weeks in a boot. After getting a CT scan, my podiatrist has concluded that the cause of my repeated stress fractures and sore foot is due to my second metatarsal being longer than my first, thus putting too much pressure on it. He has proposed a bone shortening surgery on my second metatarsal to relieve the pressure. What are your thoughts on this? I have orthotics and proper shoes, but I want to get back to playing volleyball, which is uncomfortable now. Also, he says that the saddle bone on my right foot is a symptom of my long metatarsal combined with high arches. But why would I have a saddle bone (albeit smaller), on my left foot too since my second metatarsal on my left foot is slightly shorter than my first? Thanks for your help!

  7. Amanda says:

    can saddle bone be on the back of an ankle???

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