Morton’s Toe

By Caitlin Violette, PT, DPT

What is Morton’s Toe?

Morton’s toe is a common condition where the second toe is longer than the first (great) toe. You can tell you have it by looking at your foot. If the second toe is longer than your first toe, you have this condition.

Morton’s toe is still a normal foot shape that affects many people. If you have this longer second toe, you are among 42.2% of people with this condition. Don’t be scared; some research shows that this could be an advantage for athletes. Professional athletes tend to have this condition when compared to non-athletes. In many people, there is never a problem. Some cases can cause pain, and rare cases can require surgery.

This condition can also be called Morton’s foot or Greek foot, or Royal toe. This happens because the first metatarsal on the big toe is short compared to the next toe. This condition can be misleading because the second toe appears longer. In reality, the first metatarsal is actually shortened.

Morton’s toe is also a genetic condition.

Effects of Morton’s Toe

• Pain
  • Some people eventually get pain due to how the weight is distributed among the foot, but mostly the first and second toes.
• Hypermobility and shortened first metatarsal
  • These effects can cause the first toe to be unable to work properly.
  • This causes over-pronation when walking and can increase loading on the foot and the entire body.
• Increased pressure on the second toe during the toe-off phase of gait.
• Morton’s Neuroma is a condition where the nerve between your toes is thickened, irritated, injured or inflamed. This is most common between the third and fourth toes.

 

Treatment of Morton’s Toe

Conservative management

• Physical therapy
  • A licensed physical therapist can teach you stretches and exercises for your foot to help improve your mechanics and decrease any pain you might have. To schedule for physical therapy at JOI Rehab, please call 904-858-7045.
• Orthotics
  • This can give arch support to help with decreasing excessive pronation. A local shoe store can help you find a good insole for you. You can speak with your doctor or the shoe store about custom orthotics also.
• Metatarsal pads
  • This will reduce stress on the ball of the foot. This is a very common treatment for Morton’s toe. Putting this pad on a ‘hot spot’ for increased cushion can decrease some pain.
• Wide shoebox
  • Proper footwear can often alleviate pain caused by Morton’s Toe. Avoiding shoes with narrow, pointed toes. Wide and roomy toe boxes can alleviate pain.
• Taping
  • This can help support and strengthen the arch and decrease hypermobility.

 Surgical Intervention 

When conservative measures fail to decrease your pain, surgery may be recommended. Your doctor could do one of two procedures.

• Joint resection
  • A small part of one of the toe joints is removed.
• Arthrodesis
  • An entire joint in the toe is removed. The bones will heal themselves and rejoin together.

Morton’s Neuroma is Not the Same Thing!

Morton’s Neuroma affects the ball of the foot, usually between the third and fourth toe. This pain comes from a bundle of thick tissue surrounding and pressing on nerves, not the length of the toes.

Please visit our Foot and Ankle Trending Section of our website to learn more about the foot and ankle.

By: Caitlin Violette, PT, DPT

If you would like to make an appointment with an Orthopaedic Foot Specialist, please call 904-JOI-2000 or follow the link below.