"Dr. Burton S. Schuler, Morton's Toe Expert"- Author of Why You Really Hurt, It All Starts In the Foot.

Foot Care|Fla. Podiatrist Explains Instability of Toe Joint

Dr. Burton S. Schuler, Foot Care Specialist, Podiatrist, Panama City Beach, Panama City

Dr. Burton S. Schuler,
Podiatrist, Foot Care Specialist

Authored by Dr. Burton S. Schuler,
Click here to read the Google reviews about Dr. Schuler

 Deformity of the lesser toes, most common of the second toe,  often is caused by the  instability of  a major joint in the foot known as the metatarsophalangeal joints (mpj). This  joint problem can range in form from  mild to  severity causing an irritation of the joint lining  known as a synovitis of the metatarsophalangeal joint to dislocation of the  joint. Chronic deformity  of the mpj can also be the reason for hammer toe, or  claw toes  As always a Morton’s Toe or a long second toe , is the underlying cause of  these toe problems and metatarsophalangeal joint problems.  Dr. Dudley  J. Morton,   was right in 1927 and is right now. Bunions are also affected by the Morton’s Toe but also by  metatarsophalangeal joint instability. Besides Morton’s Toe the other reasons of these  changes likely are caused by chronic

Other causes of instability  of the metatarsophalangeal joint include synovitis from arthritis,  muscular imbalance, and acute traumatic  to the ligaments of the metatarsophalangeal  joint.


The most common site for  synovitis,  of the toes takes place at  the second metatarsophalangeal joint. Normal toe position is dependent on muscle  balance. The most important of them is  extensor digitorum longus which extends the toe  at the metatarsophalangeal joint. This supplies  powerful extension force on the joint which stabilities the toe downward .  The extensor digitorum longus tendon is able to extend the interphalangeal joints of the toe only when the metatarsophalangeal joint is in a stable position

There are two sets of muscles that work on the bottom of the toe  . The second toe is unique in that there are two interossei. Normally  these muscles work by pulling the 2nd toe down at the metatarsophalangeal joint. However, as the metatarsophalangeal joint becomes chronically overworked, by the interossei  it can result in a  dorsal dislocation  of the joint.

The 2nd set of muscles is called the  lumbrical muscle and are  located on the inside side of the joint and  pulls the toe outward  also for the purpose of stabilizing the joint. While the lumbrical muscle normally passes  on the bottom of the toe and acts  as a stabilizer of  the metatarsophalangeal joint Static restraints for joint stability include the collateral ligaments and the plantar plate. Chronic irritation of the joint, with a  synovitis and joint swelling causes  degeneration,  rupture of these structures, and in the end the . metatarsophalangeal joint


One of the first thing a patients with synovitis and instability of the metatarsophalangeal joint see is a slowly progressive course of metatarsalgia, or pain and or burning on the balls of the feet. Occasionally, radiation pains into the second and third toes can occur. This is the start of a neuroma .  Initially, pain occurs while walking, but as the problem progresses, some patients may have pain with rest. On examination, a hammer toe may or may not be present. As  the deformity progresses, a plantar callus may also  develop.


In the early stages of when  there is a minimal deformity  treatment can be intraarticular cortisone injection, oral anti-inflammatory,   physical therapy,   padding and strapping  and finally orthotics   Most patients can be treated that way..

 Once there is a  significant deformity or instability , conservative treatment may not be sufficient.

There are numerous surgeries for these problems that are available depending on the deformity. The best one for you should be discussed  with your podiatric surgeon. 

About the Author:  Dr. Burton S. Schuler is a expert and authority  on the human foot. He is a  foot care specialist, podiatrist, foot doctor of Panama City, Panama City  Beach  Fl,. He  graduated   the New York College of Podiatric Medicine in 1975, and has been in private practice for over 38 years. He is an authority on the human foot and has written two books and hundreds of articles about the foot published in numerous podiatric journals and publications. He is this country’s leading authority on the Morton’s Toe, ((Long Second Toe) and its associated medical and health problems. His, first book about the Morton’s Toe,   Why You Really Hurt: It All Starts in the Foot published in 2009 is the leading authority on the Morton’s Toe. And presently has 7,000 copies in print, and sold has thousands of copies the eBooks ( Kindle) on Amazon. The book is published by the La Luz Press, Inc and is disturbed nationally by the Cardinal Publishing Group. Dr. Schuler’s next book about the Morton’s Toe, called the Morton’s Toe Book will be published the last quarter of 2013 also by the La Luz Press. In 1982, he published his first book, The Agony of De-Feet: A Podiatrist Guide to Foot Care. During his thirty eight year  career, he has written for Collier’s Encyclopedia and  has been interviewed by The New York Times, Cosmopolitan, and First in Women. Dr. Schuler has appeared on dozens of radio and television programs both here and aboard. He is a Diplomate of both the American Academy of Pain Management, and the National Board of Podiatric Examiners. Dr. Schuler is certified as a wound specialist from the American Academy of Wound Management.  He  has been a professional member of the American Diabetic Association for about 35 years. . His professional  and civic accomplishments have earned  his inclusion in  the 1999-2002  Who’s  Who in America  (Marquis)   Here is a video review of  Dr. Schuler and his book   Why You Really Hurt: It All Starts In The Foot.