Morton’s Foot, often called Morton’s Toe, is a common problem in which the second toe (next to the big toe) is longer than the big toe. In the 1930s, podiatrist Dr. Dudley Morton discovered that many people had a short first metatarsal bone. He concluded that this condition impacted their gait, causing their foot to hyperpronate-a dysfunction of the foot causing your ankles to roll in when you stand, walk, and run. Estimates for Morton’s Toe range from 15% of the population to as high as 50-60%.
The photo here shows an especially elongated second toe. In fact the second and third toes are longer.
The first metatarsal (of the big toe) is shorter than normal, and this makes the second toe appear longer than it actually is. This is usually a hereditary condition. Morton’s foot usually leads to excessive pressure on the 2nd metatarsal head (behind the second toe at the ball-of-the-foot). The constant pressure placed on the longer second toe while walking or standing can lead to callus formation under the second metatarsal head due to this excessive pressure. The repeated pressure of the longer second toe against the front of the shoe or boot may traumatize the nail. If a hematoma develops under the nail, the nail will change color and may fall off. Because of the excessive pressure on the second metatarsal head in the forefoot, Morton’s Toe is often associated with metatarsalgia.
Treating Morton’s Foot
Morton’s Toe makes buying shoes harder. It is important to fit shoes to this longest toe. Your toes need space and breathing room and your longer toe is no exception. In addition, make sure you trim your nails and file them smooth. Good toenail care, especially of this long toe, will prevent the nail from hitting on the front of the shoe-jamming the nail back into the nailbed. If you are bothered by toe pain, gel caps could help. These are a gel substance that covers the toe and many are reusable.
To get a good fit, look for shoes with a high and wide toebox. It may be necessary to use a shoe a half size to a size larger than normal in order to have space for the longer first toe. Use a nonslippery insole to keep the foot from sliding forward. The use of orthotics can align the foot by providing arch support. A metatarsal pad under the metatarsal heads of the forefoot can relieve pressure on the second metatarsal head. (A good source of metatarsal pads is Hapad) Some runners will cut a slit over or on either side of the toe to relieve pressure. Another option is to cut out a small piece of the toebox over the toe. Orthotics may also provide relief. Surgery is usually a last resort.