Understanding Morton’s Toe

By Tim Wall, MS, ATC

Morton’s Toe: What You Need to Know

Morton’s Toe is a foot condition that may alter your foot’s structure, potentially leading to discomfort or pain. This article will delve into the details of this condition, its causes, symptoms, treatment methods, and tips for prevention and self-care.

What is Morton’s Toe

Morton’s Toe is a condition where the second toe is longer than the big toe, impacting the foot’s weight distribution. Dr. Dudley Joy Morton, an early 20th-century doctor, first described this condition, hence the name.

It’s relatively straightforward to check if you have Morton’s Toe—just compare the length of your big toe to your second toe. If the latter is longer, you likely have Morton’s Toe. Keep in mind that the difference may be subtle, so pay close attention.

It’s important to note that having Morton’s Toe doesn’t necessarily mean you have a foot deformity or a medical problem. It’s considered a normal variation in foot anatomy that’s seen in a significant portion of the population. While some people with Morton’s Toe may experience foot discomfort or other issues, many lead perfectly healthy, pain-free lives.

Morton’s Toe is an orthopedic condition that may need treatment.

Image of an X-ray of two feet.

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.

Causes and Risk Factors

Morton’s Toe can cause discomfort, and understanding its causes and risk factors can help manage it more effectively. Anatomy is a crucial factor—typically, the first metatarsal bone is longer than the second, but this is reversed in people with Morton’s Toe, leading to imbalances in the foot’s weight distribution.

Genetic factors also contribute to Morton’s Toe, and it can be passed down through generations. Other factors include foot injuries, such as sprains or fractures, and wearing ill-fitting footwear. High-impact activities or sports that involve repetitive movements may also increase the risk of Morton’s Toe. However, it’s important to remember that this condition can also occur without any apparent cause.

Symptoms and Problems

Morton’s Toe may cause various symptoms and associated problems. Some people experience pain, tenderness, and swelling due to the increased pressure on the second toe. Corns, calluses, or blisters may also develop due to constant friction and pressure.

Morton’s Toe can affect your gait and balance, which can increase the risk of falls or injuries. It may also contribute to other foot conditions like bunions, hammertoes, or plantar fasciitis, and cause pain in the arches, ankles, knees, hips, or lower back. If you suspect you have Morton’s Toe or experience any of these symptoms, consult a healthcare professional for evaluation and treatment recommendations.

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.
Morton's Neuroma

Morton’s neuroma. Foot pain

Treatment of Morton’s Toe

Several treatment options are available for Morton’s Toe, ranging from non-surgical methods to surgical interventions. Non-surgical approaches often involve footwear modifications and orthotic solutions. For example, wearing shoes with a wider toe box or using shoe inserts can reduce pressure and alleviate pain.

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.
What are the best inserts for plantar fasciitis

Image of JOI Custom Orthotic Inserts

Orthotic solutions, such as custom-made shoe inserts or pads, can help redistribute pressure and provide arch support. In severe cases where non-surgical methods fail, surgical interventions may be considered, such as shortening the longer second toe or lengthening the shorter first toe. Consult with a healthcare professional to determine the most suitable treatment approach for this condition.

 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.

Prevention and Self-Care

Practicing good foot care, doing exercises, and making lifestyle adjustments can help manage Morton’s Toe. Keep your feet clean and dry, regularly trim your toenails, and wear comfortable, supportive shoes. Exercises like toe scrunches and picking up small objects with your toes can strengthen foot muscles and improve flexibility.

If your activities put excessive strain on your feet, consider low-impact exercises like swimming or cycling. Also, avoid wearing high heels or narrow-toed shoes, which can worsen symptoms. Remember, while these practices can provide relief, it’s always best to consult with a foot and ankle orthopedic specialist for a proper diagnosis and personalized treatment plan.

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

By: Tim Wall, MS, ATC

If you would like to make an appointment with an Orthopaedic Foot Specialist, please call 904-JOI-2000 or schedule online.

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