Brandt R Gibson, DPM
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Podiatrist, Neuropathy Doctor, Father of 11 and Founder of Mountain West Foot & Ankle Institute
Does it hurt every time you walk? Have you noticed that your second toe is drifting toward your big toe, possibly even crossing over it? If so, you need the help of a podiatrist to stop the drift and get you walking comfortably again.   Crossing your feet for 4th position? So pretty. Crossed toes that stay that way? Not a great look (or feel.)

Causes of Crossed Toes

Crossed toes develop over time, and have many possible causes. Sometimes, genetics are a factor—if your parents had crossed toes, you’re more likely to develop them as well.

Sometimes, the condition is more about your foot gear—high heels, for example, put too much pressure on the ball of your foot; this can injure the parts of your toe that’s responsible for keeping it in place. This is especially true when it comes to your plantar plate—if injured, toe instability sets in, and makes crossing highly likely.  

In some cases, bunions are the reason your toes start to cross. When a bony bump forms on at the base of your big toe, causing that toe to deform, other toes may be affected as well. In certain cases, bunion patients may also see crossing in their other toes.

And finally, a condition known as pre-dislocation syndrome may the reason that your toes are starting to cross. If you have pre-dislocation syndrome, the stabilizing tissue in your toe or toes (usually the second one) becomes inflamed; if the condition progresses, that tissue could even rupture, leaving your toe permanently misshapen.

Symptoms of Crossed Toes

As we mentioned above, pain is almost always a symptom of crossed toes. Pain may spread across your entire toe, it may stay local at the toe’s tip, or you may even feel the discomfort in the ball of your foot.

Other symptoms may include:

  • Corns or calluses (the hardened areas of skin can form when crossed toes change the fit of your shoes, putting more pressure on the tops and/or balls of your feet)
  • Toes may become swollen, red and irritated
  • It will become difficult, if not impossible, to find shoes that fit comfortably—especially shoes with smaller toe-boxes, like stylish-but-terrible, pointy-toed stilettos.)
  • Visibly crossed toes are the final and obvious symptom, but once you notice this visible symptom, your condition has already progressed quite a bit, so it’s important to try and get in to our American Fork podiatry office before you see the toes start to cross!

What Can I Do About My Crossed Toes?

The good news is that crossed toes, whether caused by pre-dislocation syndrome or other conditions, are usually successfully treated without surgery, especially if we catch the condition early on. Some of the more conservative treatment options we can explore include taping your toes, padding your feet, changing your shoe-type, wearing custom orthotics, employing foot immobilization and prescribing a regiment of anti-inflammatory medications.

Certain exercises may also help prevent further toe drifting, and physical therapy may be helpful in preventing the condition from progressing.

If the pain continues through treatment, or your toe deformities continue to worsen, surgery may be necessary, but that would be a last resort.

Surgery for Crossed Toes

When operating on crossed toes, you may also need to correct contributing issues, like bunions, so the condition does not recur after your surgery.

When it comes to the toes themselves, we typically remove part of your toe bone in order to correct the joint shifts. In certain cases, we may be able to repair your bone through fusion; this decision will be based, for the most part, on the location of the damage.

We will also need to relocate the joint at the ball of your foot, so it no longer allows your toe to shift over. This is usually accomplished by releasing a series of ligaments so that the joint can once again be properly aligned. Once realigned, we’ll insert a wire or something similar to make sure the joint stays where it belongs after surgery is completed.

Recovery from this type of procedure takes anywhere from six weeks to as long as three months, depending on the procedures implemented and the individual patient, but many people are able to walk fairly soon after surgery, as long as they safely follow my post-operative care instructions.

Regardless of your recovery period, surgery is something that we can all agree we’d rather skip. The key to avoiding such invasive treatment is to see me as soon as you notice pain in your foot or toes. With pre-dislocation syndrome, as with almost all foot, toe or ankle problems, the sooner you see your podiatrist, the better your outcome is likely to be. 


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