Pain In The Second Toe
QUESTION: Today, after running a half marathon (my longest run so far), I experienced a lot of pain in my index toe from the tip of it rubbing against the end of my shoe. I have run a few hundred miles in these shoes and never had this problem before. My question is: Do I need a larger shoe? There seems to be plenty of room between my toes and the end of my shoe (1/2 inch or so). How can I alleviate this pain for future long runs?
HAL’S ANSWER: If you have not had this problem before, it probably is because you have not run this far (13.1 miles) before, or maybe not at top speed before. Feet swell, particularly the feet of newcomers, who may not have fully developed the system that pushes fluids from the bottom of the body (feet) to near the top (heart) for recirculation. What you call the “index toe” is the second toe over, the one next to the Big Toe. This condition is called "Morton's Toe," describing the fact that the second metatarsal is longer than the first metatarsal. Thus it contacts the end of the shoebox first, causing pain and a blister. Shoe selection becomes vital, but that can be tricky. Your shoes may or may not be too small. They could even be too large. If you go a size up, your feet will slip around also causing blister problems. So whether shoes are too small or too large, runners with Morton’s Toe may be cursed when they get up to the longer distances. You could wait the condition out, and see if the problem happens again, or have a podiatrist examine your feet and shoes. As you continue to run and condition every part of your body, swollen feet should become less and less a problem.
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Monday, June 18, 2012 at 4:13PM | 6 Comments 
Reader Comments (6)
In my experience, sore toes are often related to running a lot of hills. Braking on the downhills causes my toes to hit the end of my shoes, which can lead to irritation. Even though my second toes are (slightly) shorter than my big toes, they see the most harm and (yikes!) lost toenails. Swelling is also a factor, and I really appreciate a generous toe box on my longer runs.
I would like to recommend barefoot running. Either minimalist shoes (Vibrant 5finger KSO) or pure barefoot.
It may sound counter-intuitive, but there is a lot of good information on YouTube.
I personally swear by it.
Shoes might be an issue, but if you are undecided between sizes, you could always try lacing your shoes in a heel lock. You can google this and there are a variety of techniques. I used to get badly blistered toes and nails falling off, but have had ZERO issues since switching my lacing technique.
OMG!! Very thankful that someone else has the dreaded longer 2nd toe! It has caused me some problems as I increase my mileage. Its very frustrating. What is even more frustrating is that my right 2nd toe is a hair longer than my left 2nd toe. I will take Hal's advice and hope that with time and training the pain lessons.
I am just wondering if it would help to put a band aid on the toe?
I too have dreaded Morton's Toe (wow there's a name - I always just called it freaky toes). I did a mountainous trail run 10 days ago, and ever since then my freaky toe has been so sore! I agree with others who have said the downhills are the cause! It flared up again after my 15km run on the weekend. Got a half marathon in 5.5 weeks time, so hoping it fixes itself soon!
I have been running for several years. I also have blister or sore toe issues with my second toe but only on faster paced runs. Can't figure it out. I can run a 22 mile training run with no issues but will race a marathon and get severe blisters. Also have a sore toe today (may not blister this time) but today I only ran 10 miles and most of it was track intervals so it was all flat running but at much faster paces than my typical run. I'm a good half shoe size up and wear Injinji toe socks and use Blister Shield powder on my toes but when I run fast my toe or toes still hurt.