This condition occurs in children because they are still growing and their bodies harbor many “growth plates”.  A growth plate, also called an epiphyseal plate, is an area at the end of a developing bone where cartilage cells change over time into bone cells. As this occurs, the growth plates expand and unite, which is how bones grow.

Physically active children run the risk of developing Sever’s disease because they put the most strain on their growing bones. Sever’s usually occurs during the adolescent growth spurt, when young people grow most rapidly. (This growth spurt can begin any time between the ages of 8 and 13 for girls and 10 and 15 for boys.) By age 15 the back of the heel usually finished growing.  As teens grow, the growth plates harden and the growing bones fuse together into mature bone.

Young people engaged in physical activities and sports that involve jumping and running on hard surfaces–such as track, basketball, soccer, and gymnastics—are ata higher risk for developing Sever’s disease.  Poor-fitting shoes can contribute  by not providing enough support or padding for the feet or by rubbing against the back of the heel (http://kidshealth.org/parent/medical/bones/severs_disease.html). 

Also, if you have a pronated foot (one that rolls in at the ankle when walking), a flat or high arch, which causes tightness and shortening of the Achilles tendon, one leg shorter than the other (short leg syndrome), or you are overweight, you are also at a higher risk for Sever’s disease.

Even if pain associated with Sever’s disease promises to elide over time through the normal maturation process of fusing bones, an article in Podiatry Today states there are still measures that can be taken to treat Sever’s disease, thus alleviating the pain associated with it

1.)   During an initial 2-3 week  period  I use physical therapy in combination with padding of strapping of the feet.

2.)  During the rest and recovery period, one can prescribe analgesics such as non-steroidal anti-inflammatory medications (NSAIDs) along with daily icing to the affected heel.

3.)  After the rest and recovery period, the “squeeze test” of the heel should be performed. If pain has elided, treatment should focus on increasing the strength and the biomechanical factors that contributed to Sever’s. At this time, patient can perform low-impact exercises such as the use of a stationary bike (at low resistance) and swimming.  They may use a treadmill if their heel is fitted with an appropriate orthoic life that protects strain in places that exacerbate the Sever’s disease.

4.)  During the next period— Orthotics with deep heel cups and a rearfoot posting for added motion control can be used.  

About the Author:  Dr. Burton S. Schuler foot doctor, foot specialist, podiatrist  of Panama City, Fl and the director of the Ambulatory Foot Clinics Podiatric Pain Management Center  and is a leading authority on the Morton’s Toe,  Long Second Toe and it associated problems. He is the author of the newly published book about The Morton’s Toe, Why You Really Hurt: It All Starts In the Foot. The book is published by the La Luz Press, Inc and is disturbed national by the Cardinal Publishing Group.  Why You Really Hurt: It All Starts In The Foot, is the story of how one bone in your foot could be the real reason for pains thru out your whole body. It is important because it offer the public new information about why millions of people suffer everyday with aches and pains, and offers new hope to get rid of problems they believed they would have to live with forever. It literally can be the “medical missing link”

  Dr. Schuler, graduated from the N. Y. College of Podiatric Medicine in 1975 at the age of twenty-four, and has been in private practice ever since. In 1982, he published his first book, The Agony of De-Feet: A Podiatrist Guide to Foot Care. During his thirty-five year professional career, he has written for Collier’s Encyclopedia and various podiatric journals and publications. He has been interviewed by The New York Times, First in Women, and other publications. Dr. Schuler has appeared on hundreds of radio and television programs both here and aboard. He is a Diplomate of the American Academy of Pain Management, and the National Board of Podiatric Examiners. Dr. Schuler is certified as a wound specialist from the American Boardof Wound Management. His professional and civic accomplishments have earned his inclusion in the 1999-2002 Who’s Who in America (Marquis). 

This is a big heel spur, see the hook growing out of the heel

Heel pain is a general term that includes many different etiologies including: plantar fasciitis, plantar fasia tear, tarsal tunnel syndrome, Baxter’s nerve entrapment, calcaneal stress fracture, calcaneal cysts, soft tissue mass, short flexor tendon tear, gout, and systemic arthritis (lupus, rheumatoid arthritis, psoriatic arthritis).  While plantar fasciitis is the most common of these conditions, it is highly possible that heel pain could be something else and thus foot and ankle specialists need to be familiar with the range of possible diagnoses (http://www.mayoclinic.com/health/plantar-fasciitis/DS00508).  One problem is that patients do not present right away when experiencing heel pain, unless they have an actual fascial tear that occurs during intense exercise, and is characterized by a “pop” sensation.  Patients who have pain but do not experience an intense tear are likely to try many home therapies and endure weeks to months of chronic low-grade pain.

Dr. Burton S. Schuler http://www.footcare4u.com/category/about-dr-schuler/   has treated thousands of heel pain cases in his over 35 years podiatry of practice An author of two books on feet, including his most recent, Why You Really Hurt: It All Starts in the Foot, Schuler links heel pain to a short or hypermobile first metatarsal bone, which is a common condition but not so commonly linked to heel pain.  Schuler makes a strong case for this connection between toe length and heel pain.  This connection was made earlier by  predecessor, Dr. Dudley Morton, who taught at Yale and Columbia  medicals schools in the 1920-1940’s;  and  who wrote extensively about the short first metatarsal bone. This medical condition came to be known as “Morton’s Toe” because of Dr. Morton’s consistent research and writing on the condition (http://whyyoureallyhurt.com/#djm). 

The first metatarsal bone is supposed to carry twice the weight as the second.  But when it is shorter, it cannot carry this weight, requiring weight to be unevenly distributed and causing the second metatarsal bone to meet the ground before the first.  The second metatarsal bone begins to do the first bone’s share of work, which places abnormal stress on many area of the foot—and that pain can spread not only to the legs but throughout the body.  Another physician influenced by Dr. Dudley Morton, Dr. Janet Travell, studied how Morton’s Toe can be linked to myofascial pain in the body.  Dr. Travell was a White House doctor to both Presidents Kennedy and Johnson, and she had attended Morton’s lectures on the foot (http://www.footcare4u.com/category/dr-janet-travell/).  Dr. Morton, Dr. Travell, and their contemporary equivalent, Dr. Schuler, remind us that causes of chronic heel pain can be demystified if we consider the cases of people with short metatarsal bones. 

About the Author:  Dr. Burton S. Schuler foot doctor, foot specialist, podiatrist  of Panama City, Fl and the director of the Ambulatory Foot Clinics Podiatric Pain Management Center  and is a leading authority on the Morton’s Toe,  Long Second Toe and it associated problems.

                                               Dr. Roger Bainster breaking the 4 minute mile

 A new book by author Christopher McDougall, Born to Run: A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seen summarizes the foundational concepts of barefoot running.  He explains that while people have focused much attention on shoe wear, it is really an issue with form.  He also argues that running free of cumbersome shoe wear is essential to human nature (http://www.miamiherald.com/2011/04/22/2180569/author-mcdougall-challenges-us.html).  Citing anthropological evidence for his support of barefoot and minimalist running, he draws extensively from the Tarahumara tribe: they live in the Copper Canyons of Mexico and run great distances without injuries because, he claims, they wear homemade sandals to run in.  Since the publication of McDougall’s book, they have figured prominently in conversations about the barefoot movement, which deems the thickly padded shoes detrimental to feet everywhere (http://www.miamiherald.com/2011/04/22/2180569/author-mcdougall-challenges-us.html#ixzz1KZZd4W00). 

As the first annual International Barefoot Runners Day approaches on May 1, 2011, the concept of barefoot running will be getting more attention. There must be something to it since so many people have testified that running barefoot or with lighter shoes—such as the Vibram Five Fingers shoe– has helped them overcome repetitive injuries or generalized pain from their athletic pursuits.  Dr. Burton S. Schuler,   author of Why You Really Hurt: It All Starts in the Foot, has practice podiatry in Panama City, Florida for over three decades and has treated world class runners and athletes.  Schuler has written on the importance of customizing your footwear and exercise routines to fit your own unique situation  This can include having your feet checked to see if you suffer from a short first metatarsal bone.  If you do, this condition is known as “Morton’s Toe” and can greatly impact your running form.  Schuler prescribes a toe pad to patients who need something to help correct the foot’s natural alignment when it hits the ground (http://whyyoureallyhurt.com/home/#tp).

 While McDougall supports the idea of moving away from thickly padded running shoes, he also acknowledges that different shoes work for different people, or the same runner may want to consider where they are running, their own form, etc.  Schuler’s advice that a short first metatarsal bone can impact running form, when combined with the latest attention paid to barefoot and minimal shoe wear, gives runners and other athletes opportunities to expand their own comfort zones, eliminate pain, and enhance their enjoyment of their sport.  Whether you believe, as McDougall does, that running is essential to human nature, and that we were all “born to run”, today runners have more research and information at their fingertips than ever before—including McDougall’s views

Fibromyalgia, which  “is characterized by poor sleep, fatigue, and widespread aching and stiffness in soft tissues, including muscles, tendons, and ligaments” is a controversial condition (http://www.merckmanuals.com/home/sec05/ch074/ch074c.html). Perhaps the best indication of its controversial status is the fact that Dr. Frederick Wolfe, the physician who initially helped coin the term “fibromyalgia” in 1990, retracted his initial belief that it is a disease. Instead, he acknowledges that it is only a clinical term and not a disease as such (http://acupuncturetoday.com/mpacms/at/article.php?id=27576). The drug company Pfizer, which has created Lyrica specifically to treat Fibromyalgia, strongly believes it is a disease and they made 1.8 billion from the drug is 2007. Since then, Cymbalta and Sevella are also available as drugs designed to combat the specific symptoms of Fibromyalgia. Regardless of the real medical status of the cluster of symptoms characterizing the disease, millions of Americans identify as fibromyalgia sufferers and seek treatment.

While drugs may be effective for many, one north Florida (Panama City) podiatrist, Dr. Burton S. Schuler, suggests that the treatment for the chronic pain that characterizes the condition may be found in a simple toe pad placed under the first metatarsal bone of your foot (http://whyyoureallyhurt.com/home/#tp). Why a toe pad, when the pain that many fibromyalgia sufferers report is not isolated in the feet or legs? In Why You Really Hurt: It All Starts in the Foot, Schuler argues that a short first metatarsal bone (longer second toe also known as “Morton’s Toe after Dr. Dudley J. Morton), throws the foot’s natural balance off; this can result in shooting pain in your legs, knees and throughout the body. The toe pad can potentially help restore the foot’s natural balance and function as a shock absorber. Schuler denotes Dr Janet Travell also had a great deal to do with myofascial pain and fibro.  In 36 years of practicing podiatry, Dr. Schuler has treated many patients who have been diagnosed with fibromyalgia and also have a short first metatarsal bone (http://whyyoureallyhurt.com/mortons-toe/fibromyalgia/). He claims that the toe pad may not work for everyone but it is definitely worth considering if you suffer from the symptoms associated with Fibromyalgia—whether it is a disease, as some would have it, or a clinical term.

Normal location of Fracture seen in March or Stress at 2nd metatarsal bone

Another problem that I believe is caused by a  Morton’s Toe is a spontaneous breaking (fracture) of the lesser metatarsal bone(s), most commonly the second metatarsal bone. In the military, these fractures are known as “march fractures.” In the private world they are called stress fractures. When military recruits go on marches, some of them end up with fractures of their second metatarsal bone for no apparent reason. I would bet anything that if the x-rays were re-examined on these men, they would show that the majority of the ones who got a March fracture also had a short or hypermobile first metatarsal bone. Again, it makes sense. If you have a either of these problems, the poor lesser metatarsal bone, especially the second, has a lot more stress and strain on it than the normal foot would have. Add to that a 60-pound backpack and double-time march, and no wonder the unfortunate second metatarsal bone breaks. I believe it would be of great benefit to our armed forces for the military doctors to consider this relationship between the first metatarsal bone and march fracture. If they did, two things would occur:

1. the number of march fractures would drop markedly  and

2.  all of the thousands and thousands of cases of various foot, back, leg, neck, and hip problems associated with the Morton’s Toe would also decrease, saving our country millions of dollars spent in treating members of our armed forces.

In the civilian world, a stress fracture is the same thing as the march fracture except it is caused by day-in day-out stress applied upon the metatarsal bone and not by marching. I have found that dancing, jogging and golfing many times will cause it. In both the march fracture and the stress fracture, it is very common that there are no signs on x-rays of the break of the metatarsal bone for several weeks. So it is common that the foot must be re-x-rayed to observe the fracture.

 There is alot of history that goes with this problem .  Aristotle wrote about around the 2nd century BC. It first appeared in the medical books  in  the mid 1800 by a  military physician   name Breithaupt, who notice this reoccurring  fracture of the metatarsals.

Like any othe fracture of the foot healing can take 8-12 weeks in a post op wooden shoe or cast.

 Of course after than YOU MUST TREAT THE MORTON’S TOE TO PREVENT IT FROM REOCCURRING 

Everybody knows or has heard of “fallen arches”. The million dollar question is: why do we get fallen arches or flat feet  to start with?

The Why:  Morton’s Toe   (Long Second Toe) causes fallen arches and flat feet. Dr. Dudley Morton wrote passionately about the true causes of fallen arches, tired feet and weak ankles in his article of 1928, and his books of 1935, 1939 and 1952. He had no doubt that all of these problems were caused by a unstable first metatarsal bone. He said there was a loss of stability at the arch when you had hypermobility of the first metatarsal bone. This loss of stability will then cause the arch to fall, tilt or collapse inwardly because it has less support than normal in keeping the arch up.

He said that once this collapsing starts toward the inside part of the foot, then a chain reaction begins to take place that can cause many problems of your foot, heel and ankle. The muscles of the ankle will attempt to fight off this unnatural inward titling or collapsing of the arch. But if the abnormal forces put upon the muscles at the ankle and at the arch are too great, then these muscles will become strained and exhausted. They will then start to hurt in their attempt to prevent the arch from collapsing and to maintain the balance of the feet.

This unsuccessful battle of trying to prevent the arch from collapsing by the muscles of the ankle is also a common cause of tired feet and weak ankles. Chronic ankle sprains can also be caused by this acquired instability at the ankle joint due to its battle of trying to prevent the arch from collapsing. This straining or exhausting of the muscles can also cause spasms at night.The good news is that these problems can be easily treated with a toe pad or a shoe insert. In reality, true “fallen arches” are a rare thing. In spite of the fact that the term is now used to refer to several foot problems, in actuality it means a total breakdown and substantial deformity of the foot. This severe condition is, in fact, a truly uncommon occurrence in our time.

 In other words if you do have hypermobility at the first metatarsal bone, you will have improper weight bearing, and in turn, will lose the stability needed in supporting the arch. This is the real reason why our arches fall causing flat feet.

How many times in your life have you heard the term “fallen arches” and had no idea what it really meant? Now, the next time you are sitting around with friends or family and someone mentions fallen arches, you can impress the heck out of him by saying , “Did you know that according to Professor Dudley Joy Morton, fallen arches are caused by the laxity of the plantar ligaments, causing a hypermobility of the first metatarsal bone, which affects the stability of the longitudinal arch?”

  How a Morton’s Toe makes you hurt, or what goes wrong 

In a perfect situation, Mother Nature makes the first metatarsal bone as long as or longer than the second metatarsal bone. “Mom” also designed the first metatarsal bone so that it would be able to carry twice the weight as the second metatarsal bone. However if the first metatarsal bone is shorter than the second metatarsal bone, then this proper lifting by the first metatarsal bone cannot take place This is because with every step, the second metatarsal bone will abnormally meet the ground before the first metatarsal bone does. When this happens, the first metatarsal bone is not able of doing its job of supporting most of the weight of the front part of the foot. The second metatarsal bone is now forced to not only to lift its share of the burden, but now is made to absorb the first metatarsal bone’s share, as well. This makes the second metatarsal bone do 100% of the work, when normally it would be doing only one third of the work. This puts a tremendous amount of abnormal stress on the second metatarsal bone. It is this “super stress” put upon the second metatarsal bone that starts the chain of events that can cause us to hurt all over. More important this stress also results in something known as pronation.

Dr. Dudley Joy Morton

                                          Dr. Dudley Morton; Father of the Morton’s Toe 

In the first half of the twentieth century, the most famous doctor in theUnited States, regarding problems of the human foot, was Dudley J. Morton, M.D. During that, time   such publications as Readers Digest, Time Magazine, and  The New York Times regularly quoted and cited him.  He was repeatedly written about in dozens of newspapers around the country, His medical books and articles on the foot were the leading authorities of their time. He was born on March 27, 1884 inBaltimore,Maryland, on his family’s farm. In 1907, Morton graduated from Hahemann Medical College in Pennsylvania

During World War I, he went to France and served as a surgeon with the famous American Ambulance of Paris.  When he returned from the war, Dr. Morton became a research associate at the American Museumof Natural History in New York, where he served as an anatomist. While at the museum, he concerned himself with the evolutionary development of the human foot. This is where he started to establish his reputation. His numerous papers and studies in the early and mid-1920s revolved around his study of primates (monkeys) 

Two Important Papers

While on the faculty of the Yale University School of Medicine, where he was an assistant professor in the Department of Surgery,  he published the two papers that would present, for the first time, what Morton’s Toe was. The first paper appeared in 1927, in the prestigious Journal of Bone and Joint Surgery. The paper  presented Morton’s theory of the short first metatarsal bone and its harmful effects on the foot.  Another  paper was  also published  in 1928,  in the Journal of Bone and Joint Surgery  that described, for the first time, another condition of the first metatarsal bone known as “Hypermobility of the First Metatarsal Bone. Both of these  conditions are responsible for a lot of problems, not only of the foot but throughout the body. 

During his life Dr. Morton wrote no less than seven books.  The most important of these books was his 1935’s The Human Foot . It was written as a textbook for the medical community. The basis of the book came directly from his 1927 and 1928 papers written for the Journal of Bone and Joint Surgery in conjunction with his years of research as an anatomist, anthropologist, and an evolutionist. His years of work at the American Museum of National History, Yale, and Columbia were also reflected in the book. In The Human Foot, Morton laid out, step-by-step, via evolution and inheritances, why we have foot problems and what to do about them. He explains (as noted previously) that the two major causes of foot problems were the short first metatarsal bone and hypermobility of the first metatarsal bone. By the time that book was published,  Dudley Morton was on his way to becoming one of  the leading authority of the foot in the medical world. 

Oh Doctor,  My Feet!    

If  The Human Foot made Morton famous in the medical profession, it was his 1939 book, Oh Doctor, My Feet! written for the average person, that made him a household name. After the release of Oh Doctor, My Feet! there was no question that Dr. Dudley J. Morton was considered by both the public and the medical community as the leading authority in this country regarding foot pain. In that book, Morton explained to the average person why their feet  really hurt, and what to do about it.  The book  was so celebrated that  Reader’s Digest  asked Dr. Morton to write an article  about the book,  in their  April 1939 issue.  In the first paragraph of the Reader’s Digest article, Morton wrote: 

“Aching, pain galled feet are among the commonest afflictions besetting mankind. Seven of ten persons suffer from foot alignment of varying severity ranging from the nagging discomfort of corns to total disability from broken down feet.”  

Morton went on to say that then, as now, millions of dollars are spent annually on corrective shoes or other devices that are of questionable benefit in healing the foot. As always, he stated the two principal reasons for foot problems are the short first metatarsal bone and or the hypermobility of the first metatarsal bone. He continued to explain how to treat these conditions by putting a pad or a platform under the first metatarsal bone.

The book was also written about in the New Yorker Magazine  and   was reviewed in dozens of newspapers across the country, from the New York Times to the Oakland Tribune (see chapter 10). At about the same time, The American Medical Association also published an article for physicians that were written by Morton based on Oh Doctor, My Feet!. Dudley J. Morton was one busy guy in 1939. 

Throw Them Out!

In January 1942, Morton presented a paper at the Academyof Orthopedic Surgeonsin Atlantic City. According to the New York Times, Morton made quite a sensation when he stated that 90% of arch supports that prop up thousands of feet ought to be thrown out the window. And, that the term “weak arches” should disappear in any discussion about the feet. Morton went on to say that, other than high heels, shoes are not normally responsible for most foot problems. He also said that fallen arches are not the cause of most foot problems; but the real problem is due to poorly distributed weight across the five metatarsal bones  (i.e. Morton’s Toe ) Time magazine, in their January 26, 1942 issue, also reported about Morton’s at this meeting.  From 1928 on, Morton was an associate professor of anatomy, at the College of Physicians and Surgeons,Columbia University in New York. He not only taught and did research at Columbia, he also was on staff at Columbia Presbertyrian Hospital, where he treated patients. He stayed at Columbia for sixteen years until he resigned on June 30, 1944. 

Later Work:

In December 1949, the Reader’s Digest again published another article about Dr. Dudley J. Morton. This time it was a highly enthusiastic profile about him entitled “Something Wrong with Your Feet.” Paul de Kruif, who was a very famous author in his own right, wrote the piece. De Kruif was most noted for his book, Microbe Hunters that  first published in 1926, and which is still in print today. De Kruif, who was a patient of Morton’s, testified that arch supports failed him, while Morton’s simple Toe Pad worked. He relates the story of how Morton discovered the importance of the short first metatarsal bone while looking at hundreds of x-rays, and how he developed the treatment for Morton’s Toe. He then goes on to say how, Morton received the scientific recognition he deserved, not only in theU.S. but overseas as well. De Kruif concluded The Reader Digest article by saying with admiration:

  “Thus thanks largely to Dr. Morton’s pioneer work, one of the most common of foot defects need no longer cause widespread suffering”. 

The Last Work   

In 1952, with Dudley Dean Fuller, a Ph.D. in mechanical engineering (what is the story with these guys name Dudley!), Morton wrote his last book called Human Locomotion and Body Form: A Study of Gravity and Man.  It was well received  and was republished  over seas by an English publishing house. There were of course, chapters on the short first metatarsal bone and hypermobility of the first metatarsal bone. But the book also reflected Dr. Morton’s thirty-plus years of work on evolution that supported his belief that the only way humans could eventually stand erect and walk was because of inheritance over millions of years. 

The Final Years 

However, Morton, like many men of his time, was a chain smoker. His grandson, Chris, clearly recalls watching ball games on TV with his grandfather, as Dr. Morton lit oneSalemcigarette after another. Unfortunately, it was this chain smoking that finally led to his death from cancer in May 1960 at the age of seventy-six 

On a regular basis patient come to see me for help with burning of their feet. Many of them has been told by their family doctor or another physician that the reason for their burning feet is due to a condition known as “Peripheral or Diabetic  Neuropathies”. A lot of these people have been prescribed various medications such as Lyrcia, Cymbalta or Neurontin for this condition, but, have not gotten any better after using these drugs for some time. Why They are not Better. The truth of the matter is that many times these people have been misdiagnosed, and don’t have Peripheral Neuropathies but really have a Morton’s Toe (Long Second Toe) . The average physician is not trained about the Morton’s Toe (Long Second Toe) and does not understand how it can cause burning feet. This oversight occurs all the time but is really important if the patient is a diabetic. I wrote about this in detail in my book Why You Really Hurt: It All Starts In The Foot, here is what I said, Do You Really Have Nerve Damage Due to Diabetes or Just Bad Feet? Please allow me to tell you this story. You are a diabetic, and like millions of other diabetics, you are most likely either on a special diet and/or taking some oral medication or insulin. One day, you go see your doctor for a scheduled appointment. He could be a general practitioner, an internist or an endocrinologist (diabetic specialist); it does not matter. In passing, you mention that you have some burning or pain on the balls of your feet. Your doctor is concerned about this because burning, pain or numbness of the feet is a frequent complication of diabetes. He may think that you are now having serious nerve changes caused by the diabetes, which are called Diabetic Neuropathies. Based on his training and experience, this is a perfectly normal assumption by your doctor. At that point, your doctor will most likely do one of two things. He might send you to a neurologist (nerve specialist) to be examined, or he might write you a prescription. After several months of taking the medication, one of two things occurs. You either feel better, or you continue to have burning or other discomforts on the balls of your feet. If you still have burning, you go back to your doctor, and he will most probably tell you to increase the dose of your medicine. But, there is another possible reason for your feet to burn or hurt if you are a diabetic I have been a professional member of the American Diabetes Association for the majority of the years I have been a foot specialist. Because of that, I do have a pretty good understanding of diabetic neuropathies… What I have seen and believe is that the burning pain, especially on the balls of the feet of fairly healthy and well-managed diabetics, very often is due to Morton’s Toe (Long Second Toe) and not due to diabetic neuropathies. Of course, there are those people who will develop nerve damage from their diabetes, but typically, these patients have been diabetics for many years, AND have not taken care of themselves. This is not the average diabetic. What I am trying to say is that if you are a diabetic, and your feet burn or hurt, it is very possible that it is not caused by nerve damage from your sugar, but rather, it is due to the fact that you have a pair of crummy feet–You picked the wrong parents! It is very possible that many diabetics are taking medications that are not benefiting them when what they really need is to treat their burning, painful feet is a simple Toe Pad. Many physicians are simply not aware of what I just told you. In fact, they would be happy and eager to know that there was another treatment, other than medication, for their diabetic patients with burning feet. Regardless, you need to find out. If you are a diabetic, of any type, you should see your podiatrist at least once a year. He will then be able to evaluate your feet. Then you will know if your problems are due to bad feet or to diabetic nerve complications, or both. (Copyright 2009 Dr. Burton S. Schuler, ) If you are being treated for Diabetic Neuropathies or Peripheral Neuropathies and you are not getting any better check to see if you have a Morton’s Toe (Long Second Toe) .

A Morton's Toe, note long 2nd toe

 ”Morton’s Toe”, or Long Second Toe means  having either one or both of two abnormal, inherited conditions of the first metatarsal bone of the foot (see next paragraphy) . Morton’s Toe was first written about in the 1920s by Dr. Dudley J. Morton. Its importance in causing pain throughout the body was taught by Dr. Janet Travell who was President Kennedy’s and Johnson’s White House physician.

What is the first metatarsal bone ?

The first metatarsal bone is a finger-like bone to which the big toe attaches to. It extents about halfway down your foot toward your heel. There are five metatarsal bones one that attaches to each toe bone. They are inside your foot so you really cannot see them. The only way to truly see the metatarsal bones is with an x-ray of the foot.

Morton’s Toe,  Long Second Toe , can be caused by one or both of two problems that can effect the first metatarsal bone.

1. The first abnormal condition, and the most noted one, that can cause Morton’s Toe is where your first metatarsal bone is shorter than your second metatarsal bone.

2. The second condition that can cause a Morton’s Toe is when your first metatarsal bone is not as stable as it should be, and as a result, has too much motion. This is known as “Hypermobility of the First Metatarsal Bone.”

Do You Have a Short First Metatarsal Bone

 Look down at your feet. Socks off please! The Long Second Toe, or Short First metatarsal bone:

 If your second toe seems longer, (and I mean even just a hair longer) than your first toe, you may have a short first metatarsal bone. The above photograph show a classic Morton’s Toe , Long Second Toe caused by a short first metatarsal bone. Note how the big toe is shorter than the second toe. Morton’s Toe is normally not this noticeable. Most of the time in a Morton’s Toe, Long Second Toe the big toe will appear to be only a little shorter than the second toe or just about the same length as the second toe.

Another way to check to see if you have a short first metatarsal bone is to hold your first and second toes down. Right behind the spot where the toes attach to the foot, you will see bumps pushing up from the top of your foot. These bumps are the heads of the first and second metatarsal bones. Using a pen, lipstick, or marker, draw a line where the bumps end (flat area) and meet the top of the foot. This spot is the very end of both of the heads of the first and second metatarsal bones. Look at both lines. If the line of the second metatarsal head is farther down your foot toward your toes than the first metatarsal head, even just a very little, then you probably have a short first metatarsal bone. Sometimes it is not necessary to draw a line on top of the foot because the relationship of the metatarsal heads can easily be seen. If this is the case, you can see without difficulty that the second metatarsal head is farther down the top of the foot than the first metatarsal head.

Frequently, people with short first metatarsal bones will also have a “webbing” between their second and third toes like the picture above. They will have a flap of excess skin that sort of looks like a “bat wing” in between the second and third toes. If you do have this webbing of the toes, it is a pretty good tip off that you do have a short metatarsal bone or you are part duck. Check to see if Mom or Dad, or anyone else in the family has this also.

Do You Have Hypermobility of the First Metatarsal Bone:

In a 1928 paper in the Journal of Bone & Joint Surgery, and in Chapter 23 of his book The Human Foot, Dr. Dudley J. Morton father of the Morton’s Toe, Long Second Toe, writes about, hypermobility of the first metatarsal bone, the other problems associated with Morton’s Toe. Hypermobility of the First Metatarsal Bone may not be as famous as its “partner in pain,” the short first metatarsal bone, but in Morton’s own words “is responsible for the widest range of foot problems”. Hypermobility refers to the excessive motion present at the first metatarsal bone. In the normal foot, there would be very little motion at this area. But in a foot with hypermobility of the first metatarsal bone, there is an excessive amount of motion that takes place.

According to Dr. Morton, the reason for the excessive motion is due to an abnormal laxity (looseness) of the plantar ligament that runs under the metatarsal bone. This laxity is either inherited or acquired in childhood. Because the ligament is abnormally loose, the first metatarsal bone is not as stable as it should be, resulting in many foot problems. Unlike the short first metatarsal bone, Long Second Toe, there is no simple reliable way that you can determine on your own if you have hypermobility of the first metatarsal bone. But because it is treated the same way as the short first metatarsal bone, with the Toe Pad, discussed in greater detail in the new book Why You Really Hurt: It All Starts In The Foot

It is not that important for you to know for sure if you have hypermobility or not.

What counts is are you any feeling better once you start to treat yourself for your Morton’s Toe? Dr. Morton recognized that besides having either a short first metatarsal bone, Long Second Toe, or hypermobility of that bone, there were many other actions, stresses, strains, and forces that affected the way your foot works and that can cause and contribute to foot problems. At no time or place did Dr. Morton ever state that having either of those conditions was a guarantee of having a foot problem or any other problem. In fact, the only thing he ever stated was that by having the short first metatarsal bone or the hypermobility of the first metatarsal bone may lead to having foot problems. In addition, it is very important that you need to be aware of  the  Aches and Pains a Morton’s Toe can cause, of your feet and body. Morton’s Toe cannot only cause foot problems but as you will see, it can cause pains all over your body.

Dr. Burton S. Schuler,  Foot Doctor, Podiatrist of Panama City Fl Dr. Burton S. Schuler is a foot doctor, podiatrist, (foot specialist) of Panama City, Fl and the director of the Ambulatory Foot Clinics Podiatric Pain Management Center. He has felt for over 30 years that a very common, but painful, medical condition known as a Morton’s Toe, (Long Second Toe) is the real forgotten reason for knee pain, back pain, hip pain, leg pains, foot pain; and many other problems in millions of people world wide. Dr Schuler says: “People you know suffer everyday with chronic aches and pains from head to toe and don’t know why. Many of them have lost all hope, and believe they will have to live with these pains for the rest of their lives. This is not the case anymore because the Morton’s Toe (Long Second Toe) may be the answer. It is good proven medicine, but most physicians have never heard of it ” Schuler also says “A Morton’s Toe is an abnormality of one bone in the foot (first metatarsal bone) that could be the real unidentified reason (the “medical missing link”) for people’s unending torments and suffering all over there body. A Morton’s Toe can cause leg cramps, (night cramps), fibromyalgia, arthritis, and numerous other problems. Knowing about the Morton’s Toe is important because it offer the public well established medical information about why millions of people suffer everyday with aches and pains , and offers new hope to get rid of problems they believed they would have to live with forever. “. In the 1920′s thru 1950′s Dr. Dudley J. Morton who taught at the Yale and Columbia Medical Schools, and who was considered this country leading authority on the human foot, stated that a problem with one bone in your foot, (Morton’s Toe) was the major reason for most foot problems. Building on his work Dr. Janet Travell, White House physician to President John F. Kennedy, and President Lyndon B. Johnson, and who was also Professor Emeritus of Medicine at George Washington University wrote that Morton’s Toe could also cause pain all over your body. She felt that the Morton’s Toe was so important that at the age of 89, she made a video to teach other doctors about the body wide problems the Morton’s Toe can cause. In his book, Why You Really Hurt: It All Starts In The Foot, Dr. Burton S. Schuler, tells the reader in a simple and easy way what a Morton’s Toe is, if they have a Morton’s Toe, (Long Second Toe) and how to treat it themselves for about $2-3.00. Along the way, he shows them the excellent medicine the Morton’s Toe is based on and the story of the two very famous physicians who wrote and taught about it for seven decades.

Dr. Burton S. Schuler, is a foot doctor and podiatrist leading authority on the Morton’s Toe Long Second Toe and it associated problems. He is the author of the leading book about The Morton’s Toe, Long Second Toe Why You Really Hurt: It All Starts In the Foot The book is disturbed national by the Cardinal Publishing Group. It will be translated to Greek this Year. Dr. Schuler, graduated from the N. Y. College of Podiatric Medicine in 1975 at the age of twenty-four, and has been in private practice ever since. In 1982, he published his first book, The Agony of De-Feet: A Podiatrist Guide to Foot Care. During his thirty-five year professional career, he has written for Collier’s Encyclopedia and various podiatric journals and publications. He has been interviewed by The New York Times, First in Women, and many other publications. Dr. Schuler has appeared on hundreds of radio shows both here and aboard. He is a Diplomate of the American Academy of Pain Management, and the National Board of Podiatric Examiners. Dr. Schuler is a certified a wound specialist from the American Academy of Wound Management. His professional and civic accomplishments have earned his inclusion in the 1999-2002 Who’s Who in America (Marquis). Dr. Burton S. Schuler, Foot Doctor, Podiatrist of Panama City Fl Dr. Burton S. Schuler is a foot doctor, podiatrist, (foot specialist) of Panama City, Fl and the director of the Ambulatory Foot Clinics Podiatric Pain Management Center. He has felt for over 30 years that a very common, but painful, medical condition known as a Morton’s Toe, (Long Second Toe) is the real forgotten reason for knee pain, back pain, hip pain, leg pains, foot pain; and many other problems in millions of people world wide. Dr Schuler says: “People you know suffer everyday with chronic aches and pains from head to toe and don’t know why. Many of them have lost all hope, and believe they will have to live with these pains for the rest of their lives. This is not the case anymore because the Morton’s Toe (Long Second Toe) may be the answer. It is good proven medicine, but most physicians have never heard of it ” Schuler also says “A Morton’s Toe is an abnormality of one bone in the foot (first metatarsal bone) that could be the real unidentified reason (the “medical missing link”) for people’s unending torments and suffering all over there body. A Morton’s Toe can cause leg cramps, (night cramps), fibromyalgia, arthritis, and numerous other problems. Knowing about the Morton’s Toe is important because it offer the public well established medical information about why millions of people suffer everyday with aches and pains , and offers new hope to get rid of problems they believed they would have to live with forever. “. In the 1920′s thru 1950′s Dr. Dudley J. Morton who taught at the Yale and Columbia Medical Schools, and who was considered this country leading authority on the human foot, stated that a problem with one bone in your foot, (Morton’s Toe) was the major reason for most foot problems. Building on his work Dr. Janet Travell, White House physician to President John F. Kennedy, and President Lyndon B. Johnson, and who was also Professor Emeritus of Medicine at George Washington University wrote that Morton’s Toe could also cause pain all over your body. She felt that the Morton’s Toe was so important that at the age of 89, she made a video to teach other doctors about the body wide problems the Morton’s Toe can cause. In his book, Why You Really Hurt: It All Starts In The Foot, Dr. Burton S. Schuler, tells the reader in a simple and easy way what a Morton’s Toe is, if they have a Morton’s Toe, (Long Second Toe) and how to treat it themselves for about $2-3.00. Along the way, he shows them the excellent medicine the Morton’s Toe is based on and the story of the two very famous physicians who wrote and taught about it for seven decades. Dr. Burton S. Schuler, is a foot doctor and podiatrist leading authority on the Morton’s Toe Long Second Toe and it associated problems. He is the author of the leading book about The Morton’s Toe, Long Second Toe Why You Really Hurt: It All Starts In the Foot The book is disturbed national by the Cardinal Publishing Group. It will be translated to Greek this Year. Dr. Schuler, graduated from the N. Y. College of Podiatric Medicine in 1975 at the age of twenty-four, and has been in private practice ever since. In 1982, he published his first book, The Agony of De-Feet: A Podiatrist Guide to Foot Care. During his thirty-five year professional career, he has written for Collier’s Encyclopedia and various podiatric journals and publications. He has been interviewed by The New York Times, First in Women, and many other publications. Dr. Schuler has appeared on hundreds of radio shows both here and aboard. He is a Diplomate of the American Academy of Pain Management, and the National Board of Podiatric Examiners. Dr. Schuler is a certified a wound specialist from the American Academy of Wound Management. His professional and civic accomplishments have earned his inclusion in the 1999-2002 Who’s Who in America (Marquis). Patients ask me all the time did I get these bunions because I wore the wrong shoe. The answer is not really. A bunion is a bump that forms over a the head of the first metatarsal bone. In most cases, the big toe joint, also known as the 1st metatarsal joint, also is enlarged due to arthritis. The toe also may be pushed toward the second toe At one time or another in their lives, most women will wear some type of shoes that are wrong for them. But only some of them will develop bunions. This is because it is not the shoe causing the bunion (shoes can make it a lot worst) but the foot you were born with. Our old friend the Morton’s Toe is the real reason in many cases. Hypermobility of the first metatarsal bone is one of the things that can cause a Morton’s Toe. If you have hypermobility, it will force the first metatarsal head (bunion bone) to move abnormally. It will cause the front part of the foot or forefoot to have excess tension on a muscle called the Adductor Hallucis. . This irregular tension pulls the Adductor Hallucis tendon away from the second metatarsal head. This is the start of a bunion. The good news is the toe pad can stop this abnormal movement, and save you from having foot surgery.