Sometimes the second toe of the foot (the one right next to the big toe)
gets a little adventurous. Sometimes it wants to strike out on its own. So,
it wanders on over and tries to climb over the big toe and ends up causing
a whole host of problems in the process. This condition, commonly referred
to as ‘crossover toe,’ is likely caused by a structural abnormality in the
foot, which puts more stress than usual on the bottom of the second toe.
(That’s where the second toe connects to the second metatarsal (one of five
long thin bones that stretch across the middle of the foot), just above the
ball of the foot.) People with hammertoes, bunions, or second toes that are
longer than the big toe may be more likely to have these adventurous second
toes. Sometimes it’s also due to an unstable arch, or tight calf muscles.
Whatever the cause, the extra stress makes the joint deteriorate; the
ligaments holding the joint in place lose strength and are no longer able
to keep the toe in place. They’re not strong enough to rein in the second
toe’s wandering heart. Eventually, the toe starts to shift over and crosses
over the big toe (hence the ‘crossover toe’ moniker).
Crossover toe is not necessarily going to be obvious when things start
going wrong. You’re likely to start out by feeling pain in the ball of your
foot near the base of your second toe. (This may be caused by tearing of
the capsule that underlies the joint.) It may feel like you’re walking
around on top of a round rock or marble. (Of course, you may actually have
a marble in your shoe. So check for stray playthings in your shoes before
you march to the podiatrist’s office.) The base of the toe might also
become inflamed (your body’s response to injury), which means that the area
might become swollen, painful, red and warm. You may also find that shoes
are getting more and more uncomfortable.
As the condition progresses, the second toe begins to obviously drift over
to one side, and may eventually rest almost entirely on top of the big toe.
It’s very important to go in to see your podiatrist when you first start to
experience symptoms. Once your toe actually gets to the point where it’s
crawling over its larger neighbor, surgery may be the only way to get
things aligned properly again. So, if you fail to find a marble when you
upend your shoe, you’ll probably want to make an appointment with your foot
Your podiatrist will likely take a look at your foot, and may manipulate it
(by pressing on or moving it) to see if he or she can pinpoint where the
pain is and see how stable the joint is. He or she may suggest X-rays or
other imaging methods (like CT scans or MRIs) to ascertain what the joint
looks like inside.
If you’re able to catch the crossover toe before it actually starts to
wander off, it will be much more likely to respond to more conservative
treatment methods. These may include treating the inflammation around the
joint to reduce the pain. This is primarily accomplished by staying off the
foot as much as possible, using ice (20 minutes on and 40 minutes off, with
a thin towel between the ice and your skin), and taking anti-inflammatory
medications such as ibuprofen or cortisone injections. Your podiatrist may
also immobilize the area with a cast or brace to give the joint time to
There are also methods your podiatrist may use to try to correct the
problem that’s causing the joint pain. He or she may tape or splint the toe
in place so that it keeps its proper position, or may suggest orthotics
(prescription shoe inserts designed specifically for you) or a stiff-soled
shoe to provide extra support to the joint. (Stiff soles help prevent
stress on the ball of the foot.) Stretching out your calves may also
provide some relief and added stability if tight calf muscles has been a
If these methods fail to reduce pain, or if the second toe has already
begun its epic journey over your big toe, then surgery will likely be
necessary to bring it back to the place it belongs. If the joint capsule is
damaged, your foot surgeon will likely repair it. It’s best to discuss
surgical options with your podiatrist, who can recommend the best
procedure, taking into account your lifestyle and the progression of your
You may feel that you’re doing your second toe a disservice by keeping it
from going where it apparently wants to: over your big toe and off into the
wilds of your foot. However, all things considered, it will probably be
happiest (and will certainly make you happier) if it’s back where it should
be: nestled nicely between your big toe and your third toe.
Call 719-543-2476 today to schedule your appointment!