Self-Treatment for Morton’s Foot, a cause of
Achilles Tendinitis, Chronic Foot Pain,
Sore Feet, Flat Feet, Pronated Foot,
Weak Ankles, and Frequent Ankle Sprains
This page will show you how to self-diagnose and self-treat Morton’s Foot, otherwise know as Morton’s Toe, Classic Greek Foot, hyperpronation of the foot, or pes valgus.
Morton’s Foot was first described in the 1930’s by podiatrist Dudley J. Morton. It is a normal variation in the structure of the human foot that is present in roughly 25% of the population. The best information currently in print about the condition is to be found in the widely acclaimed medical textbook, Myofascial Pain and Dysfunction: The Trigger Point Manual by Doctors Janet Travell and David Simons.
Ankle Instability
According to Travell and Simons, Morton's Foot creates an instability in the ankle that causes ankle weakness and frequent ankle sprains. The feet compensate by turning the toes outward, which turns the ankles inward and flattens the arch. Physical stress from this abnormal posture promotes the development of myofascial trigger points (tiny contraction knots) in the muscles of the lower leg and foot.
Mistaken Diagnoses
Pain referred by these trigger points to the ankles and foot is frequently misdiagnosed as Achilles tendinitis or plantar fasciitis. The tibialis posterior muscle deep in the calf is particularly vulnerable. This muscle is a primary support for the arch. Tibialis posterior trigger points weaken the muscle (and the arch) and send pain to the back of the ankle (and the Achilles tendon).
The soleus muscle of the calf is also affected by ankle instability. Soleus trigger points send sharp pain to the bottom of the heel. Morton’s Foot causes enough dysfunction in the legs and hips that it can be the unsuspected ultimate source of back pain, hip pain, knee pain, neck pain, and even chronic headaches.
Not a Long Second Toe!
A widely held misconception about Morton’s Foot is that it’s characterized by a long second toe. This is not true. A long second metatarsal (or short first metatarsal) is the distinctive feature.
If you have a long second metatarsal, you may also have a long second toe, or you may not. You can have a long second toe and not have Morton’s Foot. You can’t tell by simply looking at the length of your toes.
In a correctly structured foot, the first metatarsal bone should the same length as the second metatarsal, or longer. Figure 1 shows what to look for in Morton’s Foot.
Figure 1
In the skeletal view, the X’s mark the heads of the first and second metatarsals.
You can see that the second metatarsal bone (letter A) is longer than the first metatarsal bone (letter B).
Also observe that the second toe in this case is actually a little shorter than the first toe.
The other foot in Figure 1 shows the positions of four unnaturally heavy calluses typically associated with Morton’s Foot. The heaviest one appears right under the head of the second metatarsal (letter C). The other three are found along the edge of the big toe and the edges of the heads of the first and fifth metatarsals.
The Tripod
For good balance and stability, the foot should contact the ground like a tripod, with the weight evenly spread between the heel and the heads of the first and fifth metatarsals.
When the second metatarsal is too long, its head contacts the ground first and takes the full weight meant for both points at the front of the foot. This gives you a two-point support instead of a three-point support.
This is like trying to walking on ice skates. Your ankles become unstable, too easily bending in and out. To gauge the relative length of the metatarsal bones, see Figure 2.
Self-Examination
Check your feet for Morton’s Foot by simply pulling down on your toes with your thumb while pushing up on the heads of the metatarsals with your fingers from underneath to make them stand out under the skin.
Figure 2
With enough pressure, two small white spots will form on the skin over the heads of the metatarsals.
If you have a fat foot, you may not be able to see the heads of the metatarsals and will have to feel for them with the fingertips of your other hand.
Look for an extra-long web between the second and third toes that is often present in Morton’s Foot.
Don't forget to see if you have the thick callus under the second metatarsal. It may be the best single identifier of the condition.
Simple Orthotics
As shown in Figure 3 below, the simplest way to deal with Morton’s Foot is to place a thin pad under the head of the first metatarsal, sometimes called the “ball of the foot.” Cut a circle the size of a quarter for a woman or a half dollar for a man out of Dr. Scholl’s MolefoamŪ Padding. Feather the sharp edges of the pads with scissors.
Figure 3
Stick the pads on the bottoms of a pair of Ultra Durable OdoreatersŪ shoe inserts. Take care that the pads don’t extend under the second metatarsal.
Physicians often make the mistake of placing a pad under the second metatarsal and the middle of the metatarsal arch. This is done in an attempt to give local relief to pain in that area.
The effect, unfortunately, is to make Morton’s Foot worse where it exists, or to create the condition when the foot is otherwise normal.
Put pads in all your shoes and don’t forget your house slippers. You’ll be astounded at the difference it will make. You’ll find that you will immediately walk with your feet pointed forward instead of out to the side.
In addition, your ankles won’t turn in as much and your feet will no longer look quite as flat. Proper function of the foot returns very quickly and pain in the foot and other parts of the body becomes much easier to resolve.
Trigger Point Therapy
Morton’s Foot is a congenital condition. If you have it, you’ve had it all your life. Undoubtedly, it has created a good bit of chronic pain from myofascial trigger points in various parts of your body. Even after correcting for Morton’s Foot with the pads in your shoes, you might benefit from trigger point therapy.
A few doctors treat trigger points with injections. Some physical therapists treat them with stretching. The best therapy is probably trigger point massage, which is provided by specially trained massage therapists. However, there are ways to treat trigger points yourself quite effectively and inexpensively.
In The Trigger Point Therapy Workbook, nationally certified massage therapist Clair Davies has simplified Travell and Simons’s extensive research into myofascial pain and made it accessible to the layman. His methods of self-applied trigger point massage will relieve pain anywhere in the body when trigger points are the cause.
To find out more about the book and the method, please visit the homepage. To read a growing number of reviews by people who have been helped by the book, take a look at the book’s page at Amazon.com.