As early as age 14 I was diagnosed with a ligament tear in my knee, and soft cartilage in both knees. Fast forward a few decades and the musculoskeletal issues continued–with ankle sprains, cervical subluxation, kneecap subluxation, and so on. Over the years I saw everyone from orthopedists and physiatrists, to acupuncturists/herbalists, massage therapists, energy workers, chiropractors, a postural therapist, and a podiatrist. So you can imagine my *genuine* surprise when I recently learned about something called Morton’s Syndrome (also known as Morton’s Foot), and realized I had never heard of it.
Let’s take a look:
You’ll see I’ve drawn a line on these sample x-rays to point to the lengths of what are called the first and second metatarsals (the long bones shown here in the middle of the foot). Morton’s Foot is when the second metatarsal is longer than the first (yes, it’s slightly more complicated than that, but this is the gist.) So, if you take a peep at the image to the left, you’ll see that second bone noticeably pops up over the line; whereas on the right image here, it doesn’t so much. Commonly, but not necessarily, an individual with Morton’s Foot will have a longer second toe than their big toe (as seen in the top image of this post).
Luckily for us, you don’t need an x-ray to see the heads of these long bones! To check your own feet, simply curl your toes downward; for most people this will be enough to allow the heads of the metatarsals to be seen clearly. If you need an extra push, just push from the underside of your feet (just under the second toe) while your toes are curled downward. Which one is longer, your first or your second?
At first, this may not seem like such big news. After all, you can’t even find proper stats on this phenomenon– sources will vary in saying anywhere from 10% to 20% to 25% of the general population share this structural anomaly. But, remember the story of the Princess and the Pea? The body can’t rest until everything is juuuuuuust right. Ideally, and I suppose technically “normally,” our weight is evenly distributed between the heads of the first and fifth metatarsals (this is the end of the bone by the line), and the heel. This creates a ‘tripod’ effect in the foot. But for us Morton’s Foot folks, our second metatarsal bone comes down first, because of its length. (Pea!!) The body then does some circus tricks and comes up with a brand new idea – a twist here, a turn here and voila! The body can put the weight back where it’s supposed to be, on the first and fifth metatarsals. So, picture an ankle that folds down and in (i.e. pronates), and a foot that points out like a duck– a position that forces the big toe’s long bone to come down first. I picture the body like Jenga here, that as we futz with the base, twisting our supports, everything above starts to lose it… slowly, but surely!
From the toes up, you can see the repercussions of our body’s circus act in twisted ankles, knees, hips, back and neck. Morton’s Foot could be the culprit in even fibromyalgia and chronic headaches. The truth is, strong power can come in small packages– and Chinese medicine is totally awesome at treating pain with its tiny needles and many herbs; and in this case, tiny pads that go in your shoes are equally recommended! The cheapest option can be to place pads under the balls of your big toe, affixed to an flat insole in the shoe (and slippers); this rightly makes the first metatarsal the first place of impact. Right now, I’ve just got those round felt pads that go under furniture legs in my shoes to see how it goes. So far – I really notice a difference in my gait and resting posture. (I’m quite excited, actually!!) My next step is to try out these fancy insoles that even accomodate for low and high arches.
How about you? Did you know about this already? (What did you do about it? Did it work?)
Black Pine Holistic Healing 
Dear Melissa, Morton’s Foot – specifically my husband’s right foot but his left a little too – turned our lives upside down mid-year 2010 when my husband was just 40. He’s been to three podiatrists and a orthopaedic surgeon and received this advice: orthotics, stiff-soled shoes, or an operation. He’s been back and forth with orthotics that haven’t proved a lasting solution, found the best shoes he could that are really too big for him so that they can accommodate the orthotics, and is very tempted to have the operation in about a year’s time. It’s all rather hopeless-feeling. I wonder how you’re doing 1,5 years later?
Hi Katherine; thanks for your question– I have a few thoughts I can contribute! First, my personal experience: I have Morton’s toe on both sides, though more pronounced on the right. I cut out my toe pads using furniture felt pads and wore them under both right and left toes for a little over a month. Before using the pads I would have periods of instability with the left knee not tracking properly; and I started to see this get worse with wearing the pads. (The right side felt quite good, though.) To be sure it was the pads aggravating the left knee, I took them out for about a week or two, and then tried them again for a month. Wouldn’t you know it, the instability got better when I took them out, and worse again when I put them in. Not having met a Western medicine practitioner yet who’s heard of Morton’s toe/foot, let alone treated it, I had yet to find a practitioner to consult with on the subject. Since I was unsure what it would do to my gait if I only wore a pad under one side, I ended up removing them and focused on my shoe choice instead.
I met a runner who was a self-declared morton’s foot expert at a barefoot running shoe store (unfortunately, the store closed before I got to ask him more!) who recommended strengthening the foot arches and using barefoot shoes (other sources online say weak arches is irrelevant). Nonetheless, I’ve been wearing men’s barefoot Merrell’s since (they’re wider than the women’s), and got a set of Correct Toes. A few years later, I’ve now added a set of metatarsal pads. I would say, personally, I have not yet found the complete solution. (For anyone else reading with knee instability: I found non-force chiropractic and lomi lomi massage quite helpful in gaining more stability.)
Re: your husband, without knowing what’s going on, I have some what may seem like obvious questions/thoughts– were any of the practitioners he’s seen knowledgeable in treatment for Morton’s foot (i.e. they knew what it was and had treated it both preventatively and palliatively in a number of patients)? Has he seen a structural medicine practitioner? Has he already tried the pads [for a long-term fix], while using natural medicine (e.g. acupuncture and Chinese herbal medicine) to address immediate pain [short-term fix]?
I hope you both find a light in the tunnel. I have found personally, often what’s missing is simply the knowledge of another practice of medicine. (Each practitioner only knows that in which he/she’s been trained. In this way, every practitioner is limited.) Hope is keeping up the stamina to find it! May you both find what’s needed easily and quickly; and may the outcome be for your husband’s greatest and highest good!
Some links that might be helpful:
Success story with toe pads: http://charlybnorman.wordpress.com/home-5/mortons-toe/
Details on Morton’s foot from a podiatrist: http://www.footcare4u.com/mortons-toe-what-is-it-what-causes-it-how-to-treat-it/
Dear Melissa, thank you. I have returned to your letter four times now to reply but get caught up in all the rich content you offer, and put off replying until I have the “full picture”. I recognize now that’s still a way away, so this serves to thank you very much for your generous and thoughtful response.
In answer to your “obvious questions” 🙂 No, actually, none of the three podiatrists nor the orthopaedic surgeon was knowledgeable about treating Morton’s foot. Well, it could be argued that they were, and that the treatment they profer is either orthotics or surgery. As you point out, they’re not informed of other practices of medicine and other ways of treating this condition. If they did introduce other options, they’d confer some credibility to them, which would be valuable to folk who aren’t readily inclined to natural medicine.
No he has not seen a structural medicine practitioner but I see there’s one in our town! Thank you for that suggestion.
Yes he’s tried pads which he’s made himself, and he’s tried the orthotics that were designed by one of the podiatrists. He says that sometimes the solution seems to cause more pain than the actual condition does.
Natural medicine? Hmm, as I say, not quite my husband’s thing.
I’ve ordered Dr Schuler’s “Why you really hurt” from the library and have much to follow up on.
Thank you so very much for your hope-inducing response. Oooh, I have one last question for you, if you don’t mind. With your Morton’s toes, are you able to walk, say, a mile? We were regular walkers until he turned 40, but now he he’s unable to do more than a few blocks. The x-ray of his worse foot is about the same as the worse one you illustrate above.
My thanks again,
Katherine.
Hi Katherine,
You’re very welcome! Glad to hear you found some helpful information here! In answer to your question, walking is the one thing with which I don’t have any trouble; I can easily walk for hours. I’ll be curious to hear what the structural medicine folks have to say about your husband’s condition. Would you be willing to give an update in a few months?
It also may be worth having a chiropractor check out his posture with and without the foot pads/orthotics– they really may be making his big picture worse.
Good luck!
Warmly,
Melissa.