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Overlapping toes

Matiwae inaki

Foot with overlapping second toe, which crosses over the big toe, compared with a normal foot. There are also bunions on the foot with an overlapping toe Overlapping toes are toes that turn in and lie on top of the toe next to them. They're also known as overriding toes.

This condition can affect any toe, but it's most common in the second and little toes. If it is not corrected, it can cause extreme irritation, pain and calluses.

Toe deformities can happen at any age. They're relatively common among pēpi (babies) and very small tamariki (children), but more common in older people.

Overlapping toes are either fixed (you cannot move them back into the correct position) or correctable (you can manually move them).

Causes of an overlapping toe

Babies and children

In pēpi, it's thought two things can cause overlapping toes: genetics (meaning it runs in families) and the position of the pēpi in the womb.

Usually when a pēpi has overlapping toes, one or both of the parents also have overlapping toes; in these cases, genetics is probably the cause. If neither of the parents has overlapping toes, it's probably the baby's position in the womb that caused it.

It's rare for tamariki to outgrow overlapping toes, and the condition can gradually become worse if it is not treated. Flexible overlapping toes can become fixed, and fixed overlapping toes can become more painful and lead to problems such as corns and calluses.

Pēpi can also have another condition called curly toes. This involves the third, fourth, and fifth toes of both feet curling under the foot, rather than one lying on top of the other. This usually is not painful, and the condition usually fixes itself by the time the tamaiti (child) is 4 years old.

Adults

Some people gradually develop overlapping toes. This can happen because of foot problems like arthritis and bunions, untreated injuries like broken toes or shoes that squeeze their toes or have high heels.

Preventing overlapping toes

You cannot avoid them if you're born with them, but you can stop them from getting worse.

The most important thing is to make sure you wear shoes that fit you properly. Podiatrists suggest you get your feet measured properly. Then, when buying shoes:

make sure there is a centimetre of space above your longest toe at the end of each shoe when you're standing
shop at the end of the day when your feet are the most swollen
always try shoes on before you buy them and make sure they are comfortable and have plenty of space. Shoe sizes vary by brand and aren't a reliable guide
make sure the tops of the shoes do not rub against your toes
avoid shoes with pointed toes
buy wide shoes with good shock-absorbing soles.

When you buy shoes for a tamaiti, make sure they're fitted properly, especially at times when the tamaiti is growing rapidly.

Treating overlapping toes

As long as an overlapping toe is not painful or affecting the way you walk, it doesn't need to be treated.

If it's painful or affecting the way you walk, the treatment depends on whether it's correctable or fixed.

Correctable

If it's correctable, strapping your toes together so the overlapping toe is in the right position can help to ease any pain, gradually return the toe to the right alignment and prevent calluses from forming.

It can help to see a podiatrist or physiotherapist for some exercises to strengthen your foot muscles or splinting if that is necessary. This can stop the overlapping toe from coming back after strapping has returned it to the correct position.

You'll need to pay to see a private podiatrist or physiotherapist. You can find a podiatrist by searching on the Podiatry NZ website. You can find a physiotherapist by searching on the Physiotherapy NZ website.

Fixed

If your overlapping toe is fixed, you may need special shoes with extra depth around the toe to ease any pressure.

It can help to consult a podiatrist to see if orthotics or toe protectors will help.

In the few cases where podiatry and physiotherapy do not help, people with overlapping toes may need surgery. If this applies to you, your health professional will refer you to an orthopaedic (bone) surgeon.

Unless the problem is badly affecting your ability to walk, you're unlikely to get surgery in the public health system and will have to pay to see a private orthopaedic surgeon.

Written by HealthInfo clinical advisers. Last reviewed April 2023.

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Page reference: 345292

Review key: HICCA-28239