Ask a Podiatrist: What is Morton’s Toe?

The term “Morton’s toe” was coined by an American orthopedic surgeon, Dudley Joy Morton. Morton’s toe is a common forefoot disorder where the second metatarsal bone (at the base of the second toe) is longer than the first metatarsal (at the base of the big toe). This condition is also known by many other names, including “Greek foot,” “Royal toe,” “turkey toe,” “LaMay toe” or “Sheppard’s toe.”

While this may seem to be cosmetic concern, the difference in length between first and second metatarsal bones may cause discomfort throughout the body because it can change your posture as well as the way you walk and run. It can also cause pain in the foot and other areas of the body.

It is estimated that 20-30% of the world’s population has Morton’s toe. Unlike other foot issues, it’s easy to recognize Morton’s toe because it can quickly be confirmed visually. In most feet, the first toe is generally the longest when compared to the other toes. However, if you have Morton’s toe, the relative difference in metatarsal bone length will make the second toe appear to be equal in length, or protrude beyond the tip of the big toe.

It is also possible to have Morton’s toe if the gap between your first and second toe looks deeper than the space between your second and third toe.

Symptoms of Morton’s Toe

Morton’s toe causes the bones to be displaced, thereby putting more. In most cases, individuals with Morton’s toe will experience frequent callus formation directly under the second metatarsal. These calluses can cause aching pain while walking. For athletes, especially runners, the second toe is also more prone to sustaining trauma from activities like distance running, sprinting or jumping.

Patients with Morton’s toe can also suffer from knee pain, hip and lower back pain. Arthritis, bunions, metatarsalgia (ball of foot pain), metatarsal stress fractures, plantar fasciitis, and hammer toes are also observed among people with Morton’s toe. This is due to the change in biomechanics to a normal gait. Younger people may not notice any serious symptoms, but over time, changes in posture and form will deteriorate soft tissue and worsen symptoms.

Causes of Morton’s Toe

Morton’s toe is hereditary. If you have it, it means someone in your lineage had the same condition. Likewise, it may be caused by a condition know as hyper mobility of the first metatarsal bone, which means that the big toe is not as stable as it should be.

Treatment of Morton’s Toe

There is no long-term fix for Morton’s toe. If you are experiencing pain, use over-the-counter pain relievers such as naproxen, ibuprofen, acetaminophen and aspirin to reduce the pain and provide temporary relief. Remember to consult with a doctor prior to taking over the counter medications if you’ve been warned about their risks to your health.

To proactively manage the discomfort, look for shoes with wider toe boxes and enough cushioning. This provides more room for your toes. Do not wear shoes that pinch your toes, and avoid high heels, which place more stress on the forefoot due to the inclined foot position. If you cannot find shoes with wider toe boxes, you can buy shoes that are one size or one-half size larger than your normal size. Runners should already be buying training shoes in a larger size than their normal streetwear, but those with Morton’s toe may need to go even larger.

The additional length will help to accommodate the extra length of the second toe, directly reducing pressure and friction, and indirectly helping to avoid other complications, such as hammer toes, bunions, etc.

If pain persists, you can use custom orthotic inserts as advised by your podiatrist. Orthotic inserts may have arch supports and metatarsal pads. The arch support helps to keep your feet aligned in relation to the rest of your body, while the pad help to share the stress in a different way so that as you walk, run or stand, there is less pressure on the second metatarsal head and the ball of your foot. While surgery is usually not recommended for Morton’s toe, a surgical procedure to resolve developing or existing complications may be recommended for pain relief.

If you’ve wondered why your second toes were longer than those on other people you know, you now have the answer. Young people are advised to practice prevention. Stick to the recommendations above, especially those concerning footwear, and monitor your toes and feet for any health changes or discomfort. Stay active, and be alert. If you’re already seeing issues related to Morton’s Toe, see Dr. Gabriel Maislos, DPM, FACFAS at Houston Foot and Ankle Care for an evaluation. Remember that bunions, plantar fasciitis, and ball of foot pain may be connected to Morton’s toe. Call (713) 541-3199 today to get started.

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Houston Foot and Ankle

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