Having a second toe that’s longer than your first toe may look a bit funny, but it’s not unusual. “It’s more common than you might think,” says Robert M. Koivunen, DPM, a foot and ankle specialist at Henry Ford Health. “Around 10% to 30% of people have it.”
A long second toe is also called a Morton’s toe. It’s a condition you’re born with that normally affects both feet. And contrary to popular belief, it’s not really your toe that’s too long. “The toe bone of the second toe isn’t necessarily longer than typical,” says Dr. Koivunen. “It’s actually that the first metatarsal—the bone that connects toes to the foot—is shorter than the second metatarsal, and that makes the second toe appear too long.”
Foot Problems Caused by A Long Second Toe
Having a longer second metatarsal bone puts increased pressure on the joint at the base of the second toe. “When you walk or run, this joint takes a lot of extra loading,” says Dr. Koivunen. “That increased load can lead to inflammation of the joint.”
The swollen joint can be painful. That extra pressure on the joint can also lead to other foot issues. You may form a callus underneath the head of the second metatarsal. You can even wind up with a stress fracture in that bone.
Over time, consistent extra pressure on this joint can affect how you walk—setting you up for arthritis in the big toe, as well as ankle and knee pain.
Depending on the sorts of shoes you wear, having a longer second toe can lead to other issues. Shoes that are too narrow in the front pinch the toes together and can make matters worse.
If the shape of your shoe routinely causes the second toe to rub against it, you may form a hammertoe. This condition results in a bend of the middle joint in your second toe—which can become permanent over time.
Foot Fixes For Problems Related To Morton’s Toe
Choosing the right footwear can help take some of the pressure off the second toe joint. “Shoes that are too flexible—like ballet flats and flip flops—put more pressure on that area,” says Dr. Koivunen. Going barefoot or wearing high heels also stresses and overloads that joint.
Instead, choose shoes with a stiffer sole that support your feet and help control motion. “A stiff shoe helps propel you forward without the metatarsal joint bending and moving too much,” says Dr. Koivunen. He recommends cushiony sneakers that have a minimal difference between the height of the heel and the ball of the foot, because they naturally propel your body forward.
Using a carbon fiber footplate under the insoles of your shoes can stiffen up the footbed, taking some pressure off your joint and helping control its motion. You can find these over the counter or have a doctor build it into a pair of custom orthotics.
What A Podiatrist Can Do
“If you’re having pain that’s not going away—even when you’re resting and icing your foot—you should see a foot specialist,” says Dr. Koivunen.
To help reduce chronic inflammation in the toe joint, your doctor may recommend oral anti-inflammatory medication or a steroid injection into the joint.
When anti-inflammatories and better shoe choices aren’t enough to keep the pain from coming back, your doctor may recommend surgery. During a procedure called a second metatarsal osteotomy, a foot surgeon cuts away part of your second metatarsal to shorten it.
“Surgery is usually a last option,” says Dr. Koivunen. “In most cases we’re able to treat it more conservatively and still help people find relief.”
Dr. Robert Koivunen is a foot and ankle specialist who sees patients at Henry Ford West Bloomfield Hospital and Henry Ford Medical Centers - Columbus, Livonia and Royal Oak.