The Center for Podiatric Care and Sports Medicine

Out of Joint: Crossover Toe Deformity

Posted by on Tuesday, July 3rd, 2012


I am an adequate swimmer. Not great, but put me in a pool during adult lap swim time and I can make it back and forth without drowning. I prefer to do the backstroke, but there’s one problem–I seem unable to swim in a straight line while swimming the backstroke. Instead, I swim on a diagonal, eventually drifting to the other side of the lane, which is a problem if there are other people trying to share the lane. Since I’m not that fast, I don’t ram into other swimmers with anything resembling an injurious force. Nonetheless, I’ve generated more than a few angry glares after a gentle collision.

You know what else can drift other than bad backstrokers? Toes. And when a toe drifts out of place, that’s a much bigger problem than when I bump into the annoyed woman with the white bathing cap.

Drifting toes? What are you talking about? I’m talking about crossover toe deformity. It’s also known as crossover second toe deformity because it mostly affects your second toe.

So what is it exactly? It’s exactly what it sounds like–the second toe drifts so that it eventually crosses over and lies on the big toe. Sometimes people think it is the same as a hammertoe because those cramped up toes may seem like they’re pressing on the big toe, but they’re different; a crossover toe really does cross over the big toe.

Why would my second toe do that?! In most cases, crossover toe is the result of poor mechanics where the person puts abnormal weight on their second toe while walking or running. The unusual amount of stress on that toe cause the ligaments around it to weaken and it slides out of place. Some people may be prone to this disorder due to other conditions: a severe bunion, a long second toe, unstable arches, and tight calf muscles. It’s also more common in women, especially older women. (Do bad shoes have something to do with it? Yes.)

What are the symptoms? Will I just take off my shoes one day and notice that my second toe is lying on top of my big toe? No–and this is really, really important. Crossover toe deformity is a progressive disorder, meaning that it gets worse if untreated. The key, then, is to catch it early. Look out for these symptoms:

  • pain in the ball of your foot, particularly a feeling like you have a small pebble or knot under your forefoot when you put weight on it;
  • swelling under the second toe;
  • discomfort while wearing shoes as the toe starts moves out of position, leaving it to rub against the top of a shoe.

The symptoms are similar to those for a Morton’s neuroma, so you need to know which you have so it can be treated correctly. A podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) can give you an accurate diagnosis and determine the right course of treatment.

Well, then, how do I treat it? If the condition is discovered in an early stage, the podiatrist will likely start off with good old-fashioned rest and ice–stay off the foot as much as possible and ice the swollen area several times a day. You can also take anti-inflammatories to help reduce the swelling and pain.

The podiatrist may choose to splint the toe to help keep the it in place as it heals. You may also be given calf stretches to do to help loosen up those muscles. Your podiatrist may also custom fit your feet for orthotics that can help alleviate the pain and pressure on the foot.

The problem with crossover toe deformity is that once the toe crosses over, it’s not coming back on its own. If the condition progresses that far, than surgery is the only way to correct it.

I’d rather not have surgery. Understandable. Seriously, everyone, if you start to experience pain around your second toe get it checked out. It may be the beginnings of crossover toe deformity, or Morton’s neuroma, or metatarsalgia. Whichever it is, you’ll be glad you caught it early so you can get your toes healthy and happy again!

So while it may be a good thing for a country song to crossover and become a hit on the pop charts, and it may be a good thing to cross over to a different culture, it’s never good for a second toe to crossover onto the big toe (the big toe is no doubt sitting there saying, “Hey. HEY. Get off!”). If you have any toe or foot issues, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.



If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.