Helping Morton's Toe Foot Pain

Morton's Toe
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Morton's toe is when the second toe is longer than the first toe (big toe). It is a common variation seen in 10% to 20% of the population. Having Morton's toe may lead to foot pain and the need to find better-fitting footwear.

Morton's toe may also be referred to as long toe or "Greek toe," as the feet seen on classic Greek statues often have Morton's toe. The Statue of Liberty, modeled after classic Greek sculpture, is a good example of Morton's toe.

It is often confused with Morton's neuroma, which also causes foot pain, but is not related to Morton's toe.

Causes 

Morton's toe is something you are born with. The length of each toe is determined by the length of the metatarsal bones—the long bones in the ball of the foot. In people with Morton's toe, the big toe metatarsal (first metatarsal) is shorter than the second metatarsal. The second toe bone (phalange) is not actually longer than the first toe bone; it is the metatarsal that connects to the phalange that is longer. Morton's toe is an anatomical variation, rather than a condition that requires correction. It may not cause pain for everyone.

Morton's Toe and Foot Pain

When you walk or run, the longest toe takes more of the pressure during the "toe off" phase of each step. In people without Morton's toe, the sturdier first toe takes on a larger stress load.

The constant pressure may cause a callus to develop at the second metatarsal head on the ball of the foot. It may also mean that the second toe bumps against a shoe's toe box, leading to black toenail and bruising.

Morton's toe may lead to overpronation—excessive rotation of the foot inward. Motion-control shoes can help correct overpronation and the problems that it brings.

Help for Morton's Toe

The right shoes, with a high and wide toe box, can prevent the constant pressure on the tip of the second toe. Lacing the shoes to prevent the foot from sliding forward in the shoe with every step can help prevent toenail damage. Selecting shoes a half size larger may also relieve the pressure on the second toe when used in conjunction with proper lacing.

For those with continued foot pain and problems, a custom orthotic can help realign and cushion the foot properly, so that the big toe takes its share of the force when stepping. Get a foot analysis at a foot store or pedorthist shop to see whether over-the-counter insoles or custom orthotics may be needed. A physical therapist may also be able to suggest coping strategies.

John Vonhof, ultrarunner and author of Fixing Your Feet, suggests that those with Morton's toe avoid slick insoles, to help prevent the foot from sliding forward in the shoe. They may also want to cut slits in the toe box to relieve pressure.

In cases of unrelieved pain, surgery may be performed to lengthen the first metatarsal or shorten the second metatarsal.

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