"My toe has a mind of its own!" As podiatrists, we have heard this many, many a time! Why would a perfectly straight toe decide to take off in another direction? A cross over toe is a toe that had lost the stabilizing network of ligaments that keep the toe straight. What that means is that if any of these ligaments holding the toe straight are be strained or torn, the toe will deviate from its normal position. How does this happen?

Well, the easiest thing to do is to look at your foot. Do you have a bunion? This is the bump on the side of the big toe joint. The most common crossed over toe is the toe next to the big toe (the second digit). It usually crosses over the big toe when you have a bunion. The bunion pretty much forces the second toe to move out of the way, and that "way" is usually up and over! You may find a toe in this position for a long time will become less flexible, and as crosses over, becomes a hammertoe at the same time! Yes, a crossed over toe is a hammertoe as well (where the toe bends down at the joint)! The pressure of the shoe can cause pain over time if the abnormal position of the toe doesn’t cause you pain first!

Another reason a toe may cross over is the result of stubbing, jamming or some other traumatic occurrence to the toe. The ligaments supporting the toe again get torn or stretched out and over time you will find your toe drifting off in another direction.

How do you fix it? Taping the toe down and over rarely works unless you see your podiatrist the day the trauma occurred and the podiatrist initiates this taping treatment and puts you non-weight bearing that day and you are willing to go through 4-6 weeks of this treatment beginning that day. Even then it is not a sure thing. Most patients, we can tell you from experience, are willing to take the chance that nothing will happen to their toe to avoid that sort of high maintenance therapy.

Because the deviation happens so gradually, by the time you notice that your toe is moving away from its usual position, you are out of luck. If your cross over is because that bunion made it move, then not only are you looking at surgery to get the toe back in place, you are looking at surgery to correct the bunion since the toe won’t stay down with the big toe shoving it back up!

Realistically, the longer you wait to have your toe evaluated, the harder it is to treat. Remember the toe is not only deviating upward, it is also deviating over. This is a toe that is wayward in two directions, making it much more challenging to fix. The longer you wait, the stiffer and "set in its ways" it gets and the harder it is to put it back in its place, even with surgery.