While most of us are born with our big toe longer than our 2nd toe, about 15-20 percent have a longer 2nd toe. If you’re one of those people you have what’s known as a Morton’s toe. Named after the American orthopedic surgeon Dudley Joy Morton, this condition occurs when the growth plate of the big toe closes too early, resulting in a shorter big toe compared to the second toe.
People with Morton's toe place more weight on their second toe than those with longer big toes. While many can live without pain or problems due to a longer second toe, it does increase the risk for several foot conditions.
Morton's Toe vs. Morton's Neuroma
First, Morton’s toe shouldn’t be confused with another condition called Morton’s neuroma. In that condition, the nerve between the 3rd and 4th toes gets enlarged and causes pain.
Morton’s Toe can lead to a couple of chronic foot problems.
Metatarsalgia and Morton's Toe
One condition is metatarsalgia which can occur in one location, such as the base of the second toe, or across the entire ball. Those involved in sports are more likely to develop this condition. In the acute stages, the problem must be evaluated to determine if there has been a severe sprain or tear in the ligaments of the bottom of the joint. Treatment can range from simple taping to the use of a walking boot. If there is a rupture, surgical intervention may be necessary. With a minor injury, simple padding or custom orthotics may solve the problem.
Calluses and Morton's Toe
Calluses can form in response to imbalances and too much pressure on specific foot locations. In Morton's toe, that pressure often ends up with calluses forming at the bottom of the foot. While calluses are easily treated, they can also be prevented by wearing shoes with a wider and deeper toe box, use of metatarsal pads, and custom orthotics.
Plantar Fasciitis, Arch Pain and Morton's Toe
Next, because people with Morton’s toe are more likely to pronate or roll their feet in excessively when they walk or run, arch pain and plantar fasciitis are also common. Controlling pronation is key to treating and preventing this problem. This can be accomplished by wearing stable and supportive shoes and getting fit for custom orthotics. Physical therapy can help with stretching and strengthening exercises.
Ingrown Toenails and Morton's Toe
Ingrown toenails can also occur if the shoes you wear don’t accommodate a longer 2nd toe. Also, anytime you disturb the toenails you’re inviting in a fungal toenail infection. The easy fix is to wear shoes that ensure your toenails aren’t hitting the top of the inside of your shoes. Keeping your nails short also helps.
Hammetoes and Morton's Toe
Tighter shoes can also put added pressure on the 2nd toe leading to hammertoes particularly if you also wear high heels. In addition to wearing shoes that accommodate your longer 2nd toe, keep heels to a height of one inch or lower.
In conclusion, while many conditions are caused and associated with Morton's toe, several treatments and preventive measures can help.
Buy stable shoes with great arch support that accommodate the longer second toe. Avoid high heels, which can place more pressure on the ball of the foot. Ask your podiatrist about custom orthotics to help treat and prevent arch pain and plantar fasciitis. Use a metatarsal pad alone or as part of custom orthotics to alleviate metatarsalgia.
