How does a Morton’s foot type relate to Morton’s neuroma?
The term Morton's foot type is often used by practitioners to describe a certain foot shape. It is in effect a foot type whereby the first metatarsal is shorter than the adjacent one. Typically, this leaves the great (first) toe somewhat short in relation to the lesser toes.
A Morton's foot type is therefore a specific kind of foot shape which does have some clinical implications. A Morton's foot type results in a relative increase in pressures through the lesser metatarsals and toes, where a neuroma can form. As such, we see a greater incidence of patients who suffer from a Morton’s neuroma with his foot type.
A Morton's foot type is managed by redistributing pressure so that the great toe and the first metatarsal receive more weight relative to the lesser toes. Typically this would be achieved with footwear alteration and in particular customised orthoses. Abnormal pressures can be readily identified at The London Podiatry Centre using our state-of-the-art gait analysis facilities. Strategies can then be undertaken to ensure that the treatment resolves in a normal distribution of pressure.
Surgery to lengthen the first metatarsal is generally not recommended because this kind of operation tends to jam and impinge the great toe joint, so in effect causing other problems. Surgery to shorten the adjacent metatarsals is fraught with risk and hence generally not recommended.
When a Morton's neuroma forms as a consequence of a Morton's foot type it is important to establish and normalise pressures within the foot. However this may not be sufficient to completely resolve symptoms and in these cases cryosurgery is often undertaken to desensitise the nerve. Furthermore, unless the pressure distributions are improved in conjunction with the treatment of the condition using cryosurgery then further reoccurrence of problems is possible.
In order to establish whether the patient has a Morton’s foot type one can simply measure the relative length of the great toe to the second. If the great toe is a centimetre or more shorter than the second toe you have a Morton's foot type.