The condition in which a patient has a longer second toe is called a “morton’s” toe, and it appears in 20-30% of the general population. This condition is a risk factor for bunions, but there is no direct link in the literature that would suggest that having a longer second toe will always result in the formation of a bunion.
- The presence of a longer second toe can change the biomechanics of weight transfer through the foot. This abnormal loading and unloading of the foot can cause a bunion to form.
- A hypermobile big toe (overly mobile / sometimes referred to as loose-jointed) can also cause abnormal stress to the big toe and cause it to deviate (bend to the inside).
Bunions are more likely to have a genetic link (if your mother or father have bunions, it is more likely that you will have a bunion). Mechanically, having a longer second toe does anatomically put a person in a greater risk category to develop many different dysfunctions and not all of them are contained to the foot itself. As identified previously, the inefficient load through the big toe can cause a bunion to develop at a faster rate, but other dysfunctions can include:
- ball of foot pain (Metatarsalgia)
- knee pain
- hip pain
- back pain
- arthritic pain from degenerative changes
- plantar fasciitis
- toe deformities
In addition to those listed above, another challenge a bunion creates is that it widens the forefoot and therefore it can be irritated or compressed by the side of the shoe or a not wide enough toe box. Abnormal walking patterns can also cause stress fractures and the presence of hard corns and calluses.
In conclusion, while a morton’s toe is not a direct cause of a bunion, it certainly can signify that you are more at risk to develop one. Ensuring you maintain proper control and mobility through the great toe is vital in minimizing that risk.