Morton’s Foot Syndrome (commonly called “Morton’s Toe) is a condition where the first metatarsal is shorter than the second metatarsal. In a normal foot, both the first and second metatarsals are of the same length. Plantar Fasciitis is a condition where there is an inflammation of the plantar fascia, a thick band of connection tissue that joins the heel bone to the toes.
The Mechanics of a Normal Stride
With each step we take, our feet alternately push off the ground. For a fraction of a second, the first metatarsal bears the weight of the entire body. As the foot rolls forward, some of the pressure is shifted to the remaining foot bones.
Altered Mechanics of a Morton’s Toe Stride
For people who have Morton’s toe, the first metatarsal is shorter than the second, rolling the weight to the second metatarsal. This second metatarsal bone wasn’t designed for that amount of pressure. To compensate, the foot overpronates (rolls in the direction of the big toe) to recruit support to hold the excess weight.
As a result, the foot is momentarily unstable. This causes a chain reaction in the body, as other muscles and joints shift from their designed movement pattern to compensate for the instability. In the process, the plantar fascia experiences stress and damage which can lead to the painful condition of plantar fasciitis.
Pain from Morton’s Toe/Plantar Fasciitis
The overpronation can lead to pain in the ankle, knees, and hips. Muscles all along the leg form trigger points and myofascial pain. It has been estimated that as much as 80% of all myofascial pain is a direct result of Morton’s Foot Syndrome. (Source: Myofascial Pain and Dysfunction: The Trigger Point Manual, by Janet G. Travell, M.D. and David G. Simons, M.D.)
Massage for Morton’s Toe/Plantar Fasciitis
Massage therapists should assess their clients’ feet for the classic signs of Morton’s Toe (a long second toe and/or hypermobility between the first and second metatarsal bones). When found, they need a two-pronged approach to treatment: educating their client how to mitigate the impact of the bone abnormality through the use of orthotics, and treating the trigger points and muscle abnormalities that have developed from the abnormal gait.
Massage CE Courses for Morton’s Toe and Plantar Fasciitis
Institute of Somatic Therapy offers two pathology courses that address foot pain. Both courses are valid for CEs for NCBTMB, Florida, Georgia, and most states.
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