If you’ve noticed an overlapping toe, you may be wondering what caused this problem. More importantly, you’ll want to fix the problem, as soon as you can. But, in order to correct a crossover toe, we have to understand why it was drifting up and over its neighbor in the first place. So, today, we’ll explore why your toes might start overlapping. Then, we’ll suggest some treatment options to get them back in their proper position.

A Hammertoe Could Also be an Overlapping Toe

Typically, hammertoes present with symptoms such as enlarged or buckled joints. (Learn more about hammertoes here.) But, in some cases, the deformities to your toes go beyond the appearance of the joint and the noticeable buckling.

In some cases, a hammertoe deformity can lead to the affected toe floating up siting on top of its neighbor, and which point you’ll notice the overlapping toe problem. Clearly, this is not a situation that you can leave untreated. First of all, crossover toes makes it tough to wear shoes, putting extra pressure on your feet every time they’re covered. In addition to being painful, this condition could also increase your chances of developing corns on top of the toes. As such, you’ll want to explore treatment options for your overlapping toe.

Bunions and Crossover Toes foot with overlapping toe due to bunion

Hammertoes and bunions often develop together, due to added pressure on your feet and toes. And, as it turns out, developing a bunion could also lead to the formation of a crossover toe. Why is that the case?

Well, when you have a bunion, the first metatarsal bone in your great toe rotates—that’s what causes the bony bump you notice on the side of your foot. At the same time, your great toe begins shifting toward your second toe. And, if you don’t stop that movement by treating your bunion, your great toe might just slide beneath its neighbor, leaving you with a crossover toe.  

Treating a Crossover Toe Caused by Bunions

As you can see, an overlapping toe is rarely a problem that develops in a bubble. So, if you want to treat your crossover toe, you’ll also have to treat your hammertoe and/or bunion. Now, if that sounds like a lot of work, it is certainly a more involved treatment plan. But think of it this way: if you don’t address the forces that made your second toe cross over your big toe, the problem will keep coming back. And that will be painful, and require many more visits to our podiatry practice in Powder Springs GA. For that reason, the only way to fully resolve your crossover toe is to also resolve your bunion, so that it stops pushing against your toe bones and causing movement.

Injury-Related Overlapping  Toes

In some cases, your crossover toe could be the result of an injury. This may be a sign that you’ve torn a ligament in the space between your toe and foot, right underneath the joint.

How could one torn ligament lead to so much toe movement? Basically, that joint is wrapped in bunch of ligaments that forms a capsule. That capsule has a thick bottom, called your plantar plate. If it tears or bursts, that injury will weaken support to your toe. As such, it loses the ability to stay in its proper place. At that point, it can lift up and over your great toe.

How can you tell if an injury to your plantar plate is causing the overlapping toe? The best way to diagnose this concern is with an MRI, since it will show Dr. Cowans if your ligament is torn or ruptured. That way, we’ll know if your overlapping toe is really a hammertoe, or a sign of an underlying injury to your plantar plate. Afterwards, we can determine the proper course of treatment.

Treating an Overlapping Toe due to Injury A foot with a crossover toe over a pool of water

After your MRI, we’ll know if you have a plantar plate injury, and we’ll also be able to determine its severity. If the injury is just beginning, we can heal your ligament with non-invasive measures. As such, we can probably correct your overlapping toe by taping it in its proper position until the ligament regains its strength.

If we correct your crossover toes with this treatment, you’ll still need to be careful after we remove the tape and allow you to resume normal activities. At this point, we’ll fit you for custom orthotics. Why will you need these custom medical devices? By correcting any imbalances in the structure of your feet, the orthotics will keep pressure off of your plantar plate so that the toe doesn’t start overlapping once again.

Now, this plan will work if your ligament weakened after an injury. But, more often, plantar plate injuries develop slowly, over time, and as the result of chronic external pressure. In that case, simply taping your toe back into the proper position won’t be sufficient to correct the problem.
So, if pressure led to your plantar plate injury—and your overlapping toe—how can you get things back to their proper positions? In this case, surgery is likely to be your best treatment option. (That’s also the case if we discover that your crossover toe is due to joint weakening caused by a hammer toe.)

However, surgery for a plantar plate injury can be complicated. We’d have to uncover the ligament beneath your second toe, making sure to anchor it to the first segment of that toe bone. In this way, we’ll be able to restore your toe alignment and undo the crossover deformity. After surgery, you’ll have to keep pressure off your foot so you can heal. That will usually mean spending several weeks in a surgical boot, and keeping your incision site covered in a protective dressing. Your activities will be limited even after you’re able to remove that boot. But most patients can return to their full activity levels within 12 weeks of surgery.

Have you noticed one toe crossing over another, and you’ve been waiting for it to go back down on its own? That’s not going to happen. And the longer you wait to get help, the harder the problem will be to correct. So, what’s the solution? Schedule an appointment with our office today, so we can evaluate the cause of your overlapping toe and present you with the appropriate treatment plan.