What To Do When Your Second Toe Is Longer Than Your Big Toe

Ever notice that your second toe is longer than your big toe? If so, you're in good company. Both the Statue of Liberty and Michelangelo's David have second toes longer than their big toes. But since you're not a statue, you're probably wondering what's the deal with the longer toe and, even more importantly, if you should be concerned about it.

THE BASICS ---

• When your second toe is longer than your big toe, you've got Morton's Toe. One in five people have it. And while it's no cause for alarm, it can cause biomechanical problems that lead to forefoot pain, plantar fasciitis or stress fractures.
• You can avoid issues related to Morton's Toe with a metatarsal pads - a simple treatment that aligns your foot and relieves pressure that can lead to progressive skeletal dysfunction.
• Metatarsal pads must be positioned correctly or they'll make foot pain worse. Find ones that can be attached, removed, and re-attached easily so you can make sure you get the right placement. 
• Tread Labs is the only insole with modular met pads. Our met pads come in three sizes and attach to any Tread Labs insole. We recommend Ramble or Pace insoles for Morton's Toe.

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WHAT YOU NEED TO KNOW ---

What Is Morton’s Toe?

Discovered more than 75 years ago by Dr. Dudley Morton, Morton's Toe affects about 15% of the population. Unlike many other foot problems, Morton's Toe is not caused by ill-fitting footwear, injuries or overuse. It's actually an inherited trait that you're born with. 

Also called Morton’s Foot Syndrome or Greek Toe, Morton's Toe is when the second toe is longer and lower than the big toe, resulting in the pressure that occurs with every step you take not being evenly distributed.

This uneven distribution of pressure causes the added weight to be shifted to the second toe, or metatarsal. Over time, this can lead to overpronation (turning inward) of the foot along with other progressive structure irregularities in your foot, ankle, knee, leg, and back.

How Do You Know If You Have Morton’s Toe?

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It's quite easy to tell if you have Morton’s Toe. All you need to do is look at your feet and determine whether your second toe is longer than your big toe. 

While there's no cause for alarm if you have Morton's Toe, you should be aware of biomechanical complications that can arise as you age. These are caused by the uneven distribution of pressure on the ball of the foot. 

This imbalance occurs because the metatarsal (ball of the foot) beneath your second toe falls lower than the big toe metatarsal, creating a deeper space between the first and second toe than between the subsequent toes.

Common Complications Of Morton’s Toe In The Feet

Complications from Morton's Toe can vary from person to person, depending on the length of the second toe in relation to the big toe, particularly when it comes to stress fractures resulting from Morton's Toe.

As Dr. Charis Eng of the Cleveland Clinic explains, "Some people just have a teeny-weeny Morton's toe, so the longer the toe, obviously, you can see where the stress lines are completely different in your legs" Dr. Eng continued, "Those are the people who would have a higher likelihood of getting stress fractures."

In addition to stress fractures, other complications from Morton's Toe include:

• Overpronation (turning inward) of foot
• Pain in the metatarsal area (ball of foot)
• Hammer toe, claw toe, and mallet toe
• Plantar fasciitis (pain in the heel or arch caused by overpronation)
• Bunions (bony protrusions) and Calluses (rough, thick skin patches)
• Morton’s neuroma (sensation of standing on a pebble or sharp object at the ball of the foot)

Because it changes your posture and the way you walk, Morton's Toe can lead to low back, shoulder and neck pain. That's why Dr. Eng recommends low-impact sports like swimming or biking for people with Morton's toe.

How Do You Treat Morton’s Toe?

First and foremost, if you have Morton's Toe, your footwear should fit properly. While ill-fitting footwear is not a cause of Morton's Toe, it can exacerbate some of the associated complications. According to foot.com, the best footwear for people with Morton's Toe has a high and wide toe box (toe area). It may be necessary to buy footwear a half size to a size larger to accommodate the longer second toe.

There are simple treatment options that can help align your foot and relieve the pressure on your feet, knees and legs that may otherwise lead to progressive skeletal dysfunction.  The most common treatment for Morton's Toe is a quite simple fix involving an orthopedic insert that raises the level of the big toe metatarsal to the level of the second metatarsal and relieves the pressure that causes foot pain.

Metatarsal Pads For Morton's Toe

Metatarsal pads are an easy way to address Morton's Toe. A metatarsal pad can relieve pain by adding support to the shaft of your second metatarsal bone. This helps reduce the pressure on the ball of your foot and re-distributing it more evenly across your foot.

The key to making it work is putting the metatarsal pad in the right spot. This can take some trial and error because if met pads are not positioned correctly, they will make things worse. There are many types of met pads available with various ways of staying in place:

• Sticking to the bottom of your foot - This method isn't ideal as the adhesive can sometime irritate the skin. It's also inconvenient to place a met pad on the bottom of your foot everyday.
• Sticking to the top of your insole - Better than sticking a met pad to the bottom of your foot, but still challenging in that the met pad can't be adjusted as needed without wearing out the stickiness of the adhesive. Additionally, the met pad can peel off inadvertently as you put your shoes on or take them off.
• Velcroing underneath your insole - This is the best method in that velcro doesn't lose its grip like adhesive so you can adjust as often as needed. Also, the met pad is protected from your foot and any dirt and bacteria that might come along with it.

Tread Labs insoles two-part system give you the ability to place a hook-and-loop backed metatarsal pad between the arch support and top cover, allowing for easy adjustment to get the placement right. And the top cover protects the met pad from dirt and bacteria, making it last longer.

When Should You See A Doctor For Morton’s Toe?

If you are experiencing pain due to Morton’s Toe, it's time to see a doctor who will examine your foot, ankle, and leg as you sit, stand, and walk. If there is evidence of a metatarsal fracture or progressive foot dysfunction, they may wish to perform imaging tests to see what’s going on at the bone, muscle, and tendon level.

If the findings suggest the root of your foot dysfunction is due to Morton’s Toe, your physician will likely suggest the proper type of shoe inserts to help you.

If your Morton’s Toe has contributed to other skeletal problems, your physician may refer you to a specialist who can address the specific issues you are experiencing.

• Podiatrist (Doctor of Podiatric Medicine)—physician who treats foot and ankle disorders
• Orthopedic (Foot and ankle) surgeon—a surgeon who specializes in the surgical treatment of foot and ankle problems
• Certified Pedorthist—specialist who has expertise in fitting and modifying footwear to address foot irregularities and conditions
• Certified Orthotist – provides mechanical devices that address foot and leg or gait irregularities
• Chiropractor – a spine practitioner and expert of the musculoskeletal system who can make adjustments in the skeletal structure and provide nerve relief or stimulation, as needed
• Osteopath – a physician or surgeon who specializes in correcting problems and injuries of the bones, tendons, and muscles
• Pain specialist—a physician who specializes in helping patients to remediate and cope with their pain using a variety of therapies, including injections, physical therapy, and oral pain medications
• Doctor (PhD) of Kinesiology—an expert in the study of motion and its effects on physical health; may also work as a physical trainer, occupational therapist, or physiologist

It's always best to seek the advice of a medical practitioner when you are experiencing pain or discomfort. They will help you determine the cause of your issues and point you in the right direction toward solving them so you can walk better, feel better, live better.

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