Morton's Toe / Inferior Metatarsal Bursitis / Pain in the ball of the Foot

Morton’s Toe is the common term for the condition of a shortened first metatarsal in relation to a long second metatarsal. This promotes an anterior position of the second metatarsal-phalangeal joint (MTPJ) in relation to the Hallux. The condition may result in the second toe extending farther than the Hallux.

The name derives from American orthopaedic surgeon Dudley Joy Morton (1884–1960), who originally described it as part of Morton’s triad also known as a Morton’s syndrome or Morton’s foot syndrome which is a congenital short first metatarsal bone, a hypermobile first metatarsal segment, and calluses under the second and third metatarsals.

Although commonly described as a disorder from a musculoskeletal dysfunction, it is sufficiently common to be considered a normal variant of foot shape where its prevalence varies with different populations, but around 10% of feet worldwide have this form. The main symptom experienced due to Morton’s toe is discomfort and callusing of the plantar second metatarsal head. This is because the first metatarsal head would normally bear the majority of a person’s body weight during the propulsive phases of gait, but these forces are transferred to the second metatarsal head because of its anterior and distal positioning.

Is a Morton's Toe a common condition?
While the prevalence of Morton's toe is less than 50% in the general population, among people suffering from musculoskeletal pain and seeking medical help it is thought to be well over 80%.
Why does a Morton's Toe cause pain?
The reason Morton's Toe is often a precursor to musculoskeletal pain is that it is associated with excessive pronation of the foot. When weight bearing, the longitudinal arch of the foot drops, and the ankle rolls inward. The cause of this motion is that the first metatarsal does not become fully and properly weight bearing until 88% of the contact gait cycle has passed.