What is up with Steven Tyler's tangled toes?

Photos of Steven Tyler relaxing on the beach in flip flops surfaced in celebrity tabloids recently -- but what caught our eyes was the rock star's mangled, tangled toes. AFP - Getty Images file

“Walk this way,” Steven Tyler wails in the Aerosmith song of the same name, but you might want to think twice about mimicking any of Tyler’s moves. His high-energy stage performances likely caused a foot ailment, deforming his foot.

Photos of Tyler’s foot surfaced recently, showing his second toe crossing over his big toe and the other digits slouching toward it. ( doesn't have rights to the photo, but you can see it here.) After several surgeries he still experiences excruciating pain, one of the reasons he became a judge on American Idol—so he could relax. He says Morton’s neuroma caused his gnarled toes.

The word “neuroma” seems to imply that there is a tumor, says Dr. Allan Boike, a podiatrist and section head of podiatry at Cleveland Clinic, who explains that it’s not a tumor (he says without using his best Schwarzenegger impression). “It’s an irritation or a fibroid.”

Morton’s neuroma is a foot condition that most often affects the nerves between the third and forth toes. Two nerves connect there and they can become trapped under the ligament, causing them to move awkwardly when a person walks, runs, or dances. The nerves thicken, leading to pain and swelling. A patient with Morton’s neuroma complains of stinging in the ball of her foot and say it feels like she is walking on a pebble or marble.

Often, patients link the onset of pain to specific shoes.

“A female will come in and says, ‘When I go to church and wear my good shoes, I have a burning, shooting-type pain in the ball of my foot,’ ” Boike says.

This is one way doctors diagnose the problem. Physicians also put pressure on the toes to determine the location of the pain or use X-ray or MRI to rule out fractures or soft tissue damage.

The exact cause of Morton’s neuroma remains unknown, but physicians agree that wearing poorly fitting shoes, which are narrow or pointed, increase a person’s chance of developing it (sorry ladies, you might need to ditch the heels). Runners, ballet dancers, basketball players, or volleyball players are more likely to suffer from it and women are 10 times as likely to have Morton’s neuroma as men.

Doctors use several noninvasive methods to treat it. Most podiatrists recommend NSAIDs, such as ibuprofen or naproxen, to reduce swelling and irritation. About 80 percent of patients feel better if they wear custom orthopedic inserts or cushions in their shoes, explain Dr. Diana Werner and Dr. Monara Dini, associate clinical professors and podiatrists at University of California San Francisco. If these solutions fail, physical therapy and corticosteroid injections often provide relief.

Additionally, Werner and Dini say an alcohol injection blocks the nerve channels, reducing the pain. And Boike adds that Cleveland Clinic uses a therapy called radio frequency ablation, a minimally invasive procedure, using radio waves to heat the nerves until they quit working and hurting.

All three podiatrists agree that surgical removal of the nerves -- which Tyler told People magazine he underwent -- should be the final option. Dini says surgery works in more than 85 percent of cases and patients can enjoy normal activity within weeks of the surgery. Surgeons remove the thickened, irritated nerves, which causes numbness in the third and forth toes.

After years of running around on stage and dancing, in poorly fitting shoes, it’s no surprise Tyler suffers from Morton’s neuroma. While none of the podiatrists have treated the rocker, they all suspect his deformity stems from something other than Morton’s neuorma. Werner and Dini imagine Tyler’s second toe sat on his first prior to developing Morton’s neuroma—or the surgery caused the deformity (a rare side-effect). If it’s the latter, they believe his neuroma is between his first and second toes, a less common occurrence.

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