Crossover Toe

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"I love my toes again.”

-Dina W.

What is crossover toe?

Crossover toe is a condition characterized by a second toe that drifts towards the big toe and eventually may lead to the toe crossing over and resting on top of the big toe. It is a progressive condition that can develop at any age, but it is most common in adults.

 

What causes crossover toe?

Crossover toe, also referred to as second metatarsophalangeal joint instability or capsulitis of the second toe, is caused when the ligaments surrounding the joint of the second toe become inflamed and weakened over time, and eventually these ligaments can no longer support and stabilize the toe. As a result, the second toe drifts from its normal position. Most cases of crossover toe can be explained by an abnormal foot structure or abnormal foot mechanics that place significant stress on the second toe joint.

 

What are the symptoms of crossover toe?

If you have crossover toe, you will likely experience:

  • Persistent pain in the ball of the foot
  • Swelling at the base of the second toe
  • Sores on the top of the crossed over toe
  • A feeling that something is stuck inside the ball of the foot or on your shoe’s foot bed
  • Pain that worsens when walking
  • Pain that worsens when the ball of the foot is squeezed together, such as when wearing tight or pointy-toed shoes

You may be more likely to develop crossover toe if you have symptoms of another toe condition such as a bunion or big toe joint arthritis (hallux rigidus).

 

What are the risk factors for crossover toe?

  • Foot anatomy – certain structural abnormalities such as flat foot, tight calf muscles and a second toe that’s longer than the big toe can make you more prone to developing crossover toe due to the additional stress exerted on the second toe joint
  • Foot conditions – crossover toe commonly occurs with other conditions of the toe including bunions and big toe joint arthritis (hallux rigidus)
  • Toe injuries – significant or repeated injuries to the second toe including fractures and stubbing the toe can damage the ligaments surrounding the joint and lead to crossover toe

 

What are the treatment options for crossover toe?

If you are experiencing persistent pain or swelling in the ball of the foot or in the second toe joint, call our office at 212‑434‑4920 or fill out the schedule appointment form on this page so Stuart Katchis, M.D. can evaluate and diagnose your condition. Crossover toe is a progressive condition that gets worse over time and treatment outcomes are significantly improved if medical evaluation is sought when symptoms first start.

 

Nonsurgical Treatment

Nonsurgical treatment options may involve:

Taking anti-inflammatory medications

Taking over-the-counter anti-inflammatory medications can considerably reduce pain. If necessary, Dr. Katchis may prescribe a stronger medication to lessen your discomfort.

Altering footwear

Trade out tight shoes and high heels for wider shoes with stiff, supportive soles. A wider foot bed and supportive sole will allow the foot to spread out and avoid excessive movement, while also minimizing the pressure on the ball of the foot.

Using orthotics

Inserts placed in the shoes can help relieve pain and swelling by repositioning the foot and reducing pressure on the affected joint.

Applying tape

Taping the affected toe will allow you to keep it in a neutral position and provide it with more stability, which may significantly reduce inflammation and pain and prevent furthering drifting.

Physical therapy

There are a number of stretches and strengthening exercises that may help reverse the muscle imbalance causing the early stages of crossover toe. Dr. Katchis may recommend that patients see a physical therapist for treatment.

Surgical Treatment

Surgery may be recommended if nonsurgical treatments will not prove effective for relieving pain, particularly in cases of more severe or advanced crossover toe where the toe is completely crossed over on top of the big toe. Once this has happened, the second toe will not return to its normal position without surgical intervention.

The type of surgical procedure recommended by Stuart Katchis, M.D. will depend upon each patient’s unique situation. Surgery for crossover toe may involve realigning the toe, repairing any damaged ligaments or tendons that support the toe and correcting any bone deformity in the foot that impacts this condition.

 

What does the recovery process entail?

Surgical treatment for crossover toe involves several weeks or months of recovery depending on the type of surgery performed. With any type of surgery for this condition, it may require you to wear a firm and flat postoperative shoe to protect your foot while the bones heal.

Whether you undergo nonsurgical or surgical treatment for crossover toe, Stuart Katchis, M.D. will provide recommendations for long-term measures designed to keep your symptoms from flaring up or worsening, such as making footwear modifications, doing physical therapy and wearing orthotics.

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