The 1st metatarsal bone (bone in the big toe) is genetically short and cannot provide adequate stability for the foot. Consequently, the 2nd metatarsal (located in the second toe) bone is forced to bear additional pressure. At toe-off, the arch and ankle often roll down and inward until the short 1st metatarsal contacts the ground.

The most common symptoms associated with Morton’s syndrome include:

• Recurrent callousing and constant tenderness under the ball of the foot (2nd toe ball joint), also called metatarsalgia.
• Aggressive joint pain both in the 2nd ball joint and mid-arch.
• Heel pain (plantar fasciitis) or aching calves (shin splints).
• Ankle, knee, hip pain as joint alignment in these areas are dependent upon the foot for stability.

The most common causes of Morton’s syndrome include:

• A congenital condition that is prevalent among 18% to 28% of the population.
• Post-operative bunion surgery can leave the 1st metatarsal bone in a shortened position.

Orthotics (Orthoses) – Must be prescribed by a physician

Custom made orthotics support the skeleton and soft tissues in the correct position. Orthotics are a long-term solution to prevent reoccurrence by controlling and / or correcting the mechanics that cause the problem. Orthotics for Morton’s syndrome may include:

• Thickening the orthotics under the first metatarsal head for more advanced cases.
• A hollowing under the first metatarsal head.
• Excavation under the 2nd metatarsal head to relieve pressure as needed.
• Prominent metatarsal pad or bar to lift and separate metatarsal heads.

Footwear

Footwear including therapeutic and orthopaedic shoes are integral to the treatment process. Certified Pedorthists are trained to fit patients with appropriate footwear. BioPed offers many types of footwear into which an orthotic device may be placed or worn alone.

Footwear for Morton’s syndrome is sized according to the length of the longer second toe and may have any of the following characteristics:

• Forefoot rocker sole – a must for chronic forefoot conditions. Off-the-shelf therapeutic footwear with a rocker can minimize the metatarsal joint bending and plantar pressure.

Modifications to footwear are also available at the discretion of the Pedorthist.