Written by: Cherri Choate, DPM
7/29/2009

This week, I had a discussion with a colleague regarding the question of:   Reverse Morton's Extension vs. a Morton's Extension for Hallux Limitus.  As a rule when someone is having 1st MPJ pain and I observe limited 1st MPJ motion, I always start with an orthotic with a Reverse Morton's Extension.  In addition to this, I recommend a stiff-soled, rocker type shoe.   In my clinical experience at least 29 out of 30 patients do well with this combination.  In my experience, if this combination makes the patient worse, then I need to consider a Morton's Extension.  On the few occasions when I have fabricated an orthotic with a Morton's Extension the primary complaint I am addressing is pain.  In the majority of patient's who are treated with a Morton's Extension, this modification buys them time until they undergo fusion (auto or surgical).  This time frame may be months, or in many cases, years.  Either way, most patients with Hallux Limitus symptoms will benefit from the mechanical advantages offered by custom foot orthoses.

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