Morton’s toe, often referred to as Greek Foot or Index Minus, is a common anatomical variation where the second toe appears longer than the big toe. This occurs because the first metatarsal bone is shorter than the second metatarsal bone. This inherited condition is present in an estimated 15% to 30% of the general population. Although it is a normal foot shape, it can sometimes alter the foot’s biomechanics, which may lead to discomfort or pain. This article clarifies the anatomy of Morton’s Toe and discusses how to manage any resulting issues.
Understanding Morton’s Toe Anatomy
Morton’s Toe is defined by a structural difference in the forefoot skeleton, where the first metatarsal, which supports the big toe, is shorter than the second metatarsal. This length difference causes the second toe to protrude further than the big toe. This structural variation is generally inherited, often resulting from the early closure of the growth plate in the first metatarsal bone.
It is important to distinguish this structural variation from Morton’s Neuroma, a painful nerve condition. Morton’s Neuroma involves a thickening of nerve tissue, typically between the third and fourth toes, causing sharp, burning pain in the ball of the foot. Morton’s Toe is a bone structure variation, while Morton’s Neuroma is an irritation of a nerve.
Why the Structure Can Cause Discomfort
Discomfort related to Morton’s Toe results from altered weight distribution during the gait cycle. In a typical foot, the big toe and its corresponding metatarsal bear the majority of the load during the push-off phase. When the first metatarsal is shorter, the second metatarsal bone is forced to accept a disproportionate amount of weight and pressure. This change in foot function shifts pressure forward, disrupting natural alignment and balance.
Excessive pressure on the head of the second metatarsal can lead to several common symptoms. This includes metatarsalgia, which is general pain and inflammation in the ball of the foot. The constant friction and pressure can also cause the formation of thick calluses or corns directly underneath the head of the second metatarsal. Over time, the altered mechanics may also contribute to foot conditions like arch pain, plantar fasciitis, or stress fractures in the second metatarsal.
Adjusting Footwear and Activity
Managing discomfort related to Morton’s Toe focuses on redistributing pressure away from the overloaded second metatarsal. Footwear plays a significant role in both the prevention and management of symptoms. Shoes should have a wide and deep toe box to comfortably accommodate the longer second toe and prevent friction or compression.
The use of orthotics or specialized inserts is an effective non-surgical strategy. Custom or over-the-counter orthotic devices support the arch and realign the foot to promote more balanced mechanics. Specifically, a metatarsal pad or dome placed behind the second metatarsal head helps to lift and offload the bone, encouraging proper propulsion through the big toe. If symptoms are severe, modifying activities to reduce high-impact stress, such as switching from running to swimming, may also provide relief.