What is Morton's toe? My 13-year old daughter has been trying to learn toe-pointe dancing but extreme pain occurs every time she's up on pointe. The doctor says a Morton's toe is causing this pain.

Morton's Toe is a common forefoot disorder in which the second toe is longer than the first (big) toe. It doesn't always cause pain for the average person, but it's a definite problem for many dancers.

Morton's toe results in too much pressure on the second metatarsal head when the dancer is on pointe. The metatarsal is the long bone in the main part of the mid-foot. It sits between the bones of the ankle and the ends of the toes.

Morton's toe can be managed in young ballerinas. The first step is to choose proper footwear. Her regular shoes should have a high and wide toe box (area where the toes rest inside the shoe). Narrow, pointed shoes are a "no-no" for this condition.

If the problem is mild, a special shoe insert or liner can be used inside the pointe shoes. The cushion lies against the big toe and the third toe. This makes a space for the long second toe to lie straight. There's no pressure from the end of the box.

You can find these cushions on-line at
http://www.dancer.com/cushion.html
. They are designed by a company called Gaynor Minden, the maker of a special pointe shoe as well. If the tip of the second toe is pushed under it can cause a problem called hammer toe. If this is happening, your daughter may need to see an orthopedist first.

Reference: 

James S. Davitt, MD, et al. An Association Between Functional Second Metatarsal Length and Midfoot Arthosis. In Journal of Bone and Joint Surgery. April 2005. Vol. 87-A. No. 4. Pp. 795-800.

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