Hokas models vary a lot in width. Here's what I wrote about Morton's Neuroma in my book on tips about running.
Tip 29. Morton’s Neuroma
Morton’s Neuroma is a nasty injury that can put you on crutches or have you limping for weeks. It’s an inflammation around the bones of the ball of the foot. Often, the cause is a shoe that is too narrow in the toe box. This squeezes the bones of the foot together, causing inflammation and swelling because the bones rub together with each step. EDITED TO ADD: When the "knuckles" of the metatarsals in the forefoot are squeezed together, one "knuckle" is forced to ride a little higher than the others. That's not usually a problem when walking, the knuckle can just stay in that higher position, but when running, the impact slams that bone down between the other bones. Over time, it causes inflammation and swelling... Morton's Neuroma.
Since this happens about 10,000 times in an hour run, it’s a wonder this problem isn’t more common, but there are ways to fix it. The logical step is to buy a half-size larger shoe or a shoe with a wider toe box. That’s definitely what you should do in the future, but there may be ways to salvage your existing shoes.
Several solutions for Morton’s Neuroma are the same as for little toe blisters. First, make your forefoot smaller by wearing a thinner sock. It’s hard to find super thin men’s socks, but they’re easy to find in the women’s department. They come in neutral colors and aren’t any thicker than a T-shirt. A women’s large fits my size 9½ foot.
Thinner socks will help, but they might not be enough by themselves. So, the next step is to make the forefoot of the shoe wider. First, replace the existing insert with a thinner insert from another pair of shoes. Then, re-lace the shoes, skipping the bottom set of eyelets nearest the toes.
Taken together, these three steps—thinner socks, a thinner insert, and skipping the bottom eyelets—should be enough, but if it doesn’t resolve the problem, you can make even more room by modifying the shoe itself.
Many running shoes have a protective leather strip that runs from the bottom eyelets down the outside of each shoe to-wards the little toe. They might also have a leather strip that runs around the front of the toe box ending just past the little toe. This material doesn’t stretch and contributes to the tight-ness of the shoe, but it can be removed. Cut the stitching care-fully along this leather covering. Then cut the strips off the shoe in the area of the little toe. There will be mesh underneath, so cut carefully to leave the mesh intact and in place.
If this doesn’t work, there’s one final step you can try. Most shoes have a reinforcing piece of leather where the tongue is attached to the toe box. Cut through that material making a vertical slit about one inch long going towards the toe of the shoe. You should cut through the underlying mesh as well. When finished, you’ll have a slit about a half inch into the tongue and about a half inch past the tongue going towards the toe of the shoe.
This slit will be almost invisible with the shoe off, but when you put the shoe on, it will bulge open a bit. The reason it bulg-es open is that your shoe is too narrow. Remember, that’s been the problem all along, so next time, buy a half size larger or a different shoe with a wider toe box.
If these modifications don’t resolve the problem, you should throw these shoes away. Even if you stop running until it heals, the shoe might cause the same problem when you start running again. You shouldn’t even keep them for walking.
Bonus Tip: During rehab, it’s important that your toes have room to splay out, so you may need wider casual shoes to wear when you’re not running. This is important because once you get Morton’s Neuroma, you’re prone to getting it again.
EDITED TO ADD: When you try on new shoes or put on the old ones that are causing Morton's Neuroma, is your little toe snug or can you move it a little. If it's snug, your foot will swell as you run, making your foot a little wider. Generally speaking, if you can't wiggle your toes at least a little, you need a half size larger shoe, a shoe with a wider toebox, a thinner sock, or a thinner insert.
