Morton’s Toe: When the Second Toe Is Longest

Lots of people think they have a weird foot because it looks like the second toe is longer than the big toe. This is actually quite common, however. In spite of being fairly commonplace, Morton’s toe—as the condition is known—can actually cause or contribute to a variety of medical issues. Here at Austin Foot and Ankle Specialists, we can provide effective treatment when this second toe is causing problems.

Why Your Second Toe Is Longer

You may have Morton's Toe if you second toe is longer than your first and third.Morton’s toe is the common term for the condition where there is a long second metatarsal and a shortened first metatarsal (in relation to its neighbor). This leads to a situation where the second metatarsophalangeal joint (MTPJ) is actually farther forward than that of the big toe. As a result, the second toe extends farther than the first one.

This condition is named after American orthopaedic surgeon Dudley Joy Morton, who originally described it as being part of his “triad,” which was also known as Morton’s foot syndrome. This syndrome was marked by a congenital (condition present at birth) short first metatarsal bone, a hypermobile first metatarsal segment, and callusing found under the second and third metatarsals.

While this is commonly noted as being a disorder that stems from a musculoskeletal dysfunction, it is “normal enough” that we consider it to simply be a normal variant of foot shape. Interestingly, it’s prevalence within a given population does tend to vary in different social groups, but experts estimate that a total of around ten percent of all people worldwide have this extended second toe.

Issues from Morton’s Toe

The most common problem that is caused by the condition tends to be callusing and/or discomfort of the ball of the foot, particularly at the base of the second toe. Given that the first metatarsal head is usually responsible for bearing the majority of bodyweight during the propulsive phases of gait (when the foot pushes off the ground), the forces that come with taking a step are shifted to that second toe, since it is the farthest point forward.

Pain may also be experienced in the arch of the foot by those who have this particular structure variance. This is most commonly felt in the “ankle end” of those first and second metatarsals. There can also be issues for those who live in cultures, like ours, where shoe-wearing is the norm. Shoe models that feature a profile that does not accommodate the longer second toe may lead to ingrown toenails or other nail issues.

Morton's Toe and Pain

While a smaller percentage of the general population of the U.S. have this condition, it is widely estimated that well over 80% of those who suffer from musculoskeletal issues and seek medical help have this foot structure variance.

This condition is often a precursor to musculoskeletal pain because it can contribute to excessive pronation. At the very least, it is safe to say that a longer second toe has a common association with overpronation. The reason behind this is that the longitudinal foot arch drops while bearing weight, which leads to the ankle rolling inwards. Since the first metatarsal does not fully and properly bear weight, it results in the excess motion until almost 90% of the gait cycle has passed.

Effective Overpronation Treatment in Austin, TX

It is only in rare cases that we would need to use surgery to care for this particular condition. In most cases where a long second toe is causing problems, we can effectively treat the condition with the use of conservative methods to restrict the excessive pronation. This will possibly entail the use of custom orthotic devices that are crafted especially for your feet.

Contact our Austin, TX office for more information on this subject by calling (512) 328-8900. If you are experiencing foot or ankle pain, for any reason, simply schedule an appointment online and we will look forward to providing the care and relief you need.

Dr. Craig H. Thomajan, DPM, FACFAS, FAENS
Founder and Managing Partner of Austin Foot and Ankle Specialists