Elana Kunselman

Solving Feet Dilemmas

You Might Have Pes Planus?

Overview

Acquired Flat Feet

Flat feet can lead to extreme stress or inflammation of the plantar fascia, possibly causing severe discomfort and leading to other foot problems. Without properly supported arches, simple movement can pull your body out of alignment and cause stress, strain and fatigue to your lower body.

Causes

The most common acquired flat foot in adults is due to Posterior Tibial Tendon Dysfunction. This develops with repetitive stress on the main supporting tendon of the arch over a long period of time. As the body ages, ligaments and muscles can weaken, leaving the job of supporting the arch all to this tendon. The tendon cannot hold all the weight for long, and it gradually gives out, leading to a progressively lower arch. This form of flat foot is often accompanied by pain radiating behind the ankle, consistent with the course of the posterior tibial tendon. Compounding matters is the fact that the human foot was not originally designed to withstand the types of terrain and forces it is subjected to today. Nowhere in nature do you see the flat hard surfaces that we so commonly walk on in present times. Walking on this type of surface continuously puts unnatural stress on the arch. The fact that the average American is overweight does not help the arch much either-obesity is a leading cause of flat feet as the arch collapses under the excessive bodyweight. Furthermore, the average life span has increased dramatically in the last century, meaning that not only does the arch deal with heavy weight on hard flat ground, but also must now do so for longer periods of time. These are all reasons to take extra care of our feet now in order to prevent problems later.

Symptoms

Arches can be seen as ?rolling downward? or collapsing when walking. Pain may present in lower back, hips or knees. Pain may be present on the bottom of the heels, within the arch, within the ankles or even the forefoot. Swelling can occur. Pain may occur in the anterior leg muscles.

Diagnosis

People who have flat feet without signs or symptoms that bother them do not generally have to see a doctor or podiatrist about them. However, if any of the following occur, you should see your GP or a podiatrist. The fallen arches (flat feet) have developed recently. You experience pain in your feet, ankles or lower limbs. Your unpleasant symptoms do not improve with supportive, well-fitted shoes. Either or both feet are becoming flatter. Your feet feel rigid (stiff). Your feet feel heavy and unwieldy. Most qualified health care professionals can diagnose flat feet just by watching the patient stand, walk and examining his/her feet. A doctor will also look at the patient's medical history. The feet will be observed from the front and back. The patient may be asked to stand on tip-toe while the doctor examines the shape and functioning of each foot. In some cases the physician may order an X-ray, CT (computed tomography) scan, or MRI (magnetic resonance imaging) scan.

Is flat footedness genetic?

Non Surgical Treatment

Switch activities for a little while. If you?re a super athlete, you don?t want to hear that you need to take a break, but there?s no way around it. You need to lay off the high impact sports like basketball, tennis and running. Don?t panic-there?s no shortage of alternatives. Find a high school track that?s open to the public and try going for a run. Many athletic programs use spongy synthetic materials to pave tracks instead of concrete. This is much easier on all the joints and tendons, not only in your feet but your legs and ankles. You can also try running on dirt trails or stable grassy areas. Take up swimming for a little while. This is actually an ideal activity for your arches. The buoyancy of water takes weight off our feet, but still allows for aerobic activity. Many gyms and activity centers also offer various water sport classes. In no time flat, you?ll be on your way to healthier feet.

Surgical Treatment

Adult Acquired Flat Foot

Surgery is typically offered as a last resort in people with significant pain that is resistant to other therapies. The treatment of a rigid flatfoot depends on its cause. Congenital vertical talus. Your doctor may suggest a trial of serial casting. The foot is placed in a cast and the cast is changed frequently to reposition the foot gradually. However, this generally has a low success rate. Most people ultimately need surgery to correct the problem. Tarsal coalition. Treatment depends on your age, extent of bone fusion and severity of symptoms. For milder cases, your doctor may recommend nonsurgical treatment with shoe inserts, wrapping of the foot with supportive straps or temporarily immobilizing the foot in a cast. For more severe cases, surgery is necessary to relieve pain and improve the flexibility of the foot. Lateral subtalar dislocation. The goal is to move the dislocated bone back into place as soon as possible. If there is no open wound, the doctor may push the bone back into proper alignment without making an incision. Anesthesia is usually given before this treatment. Once this is accomplished, a short leg cast must be worn for about four weeks to help stabilize the joint permanently. About 15% to 20% of people with lateral subtalar dislocation must be treated with surgery to reposition the dislocated bone.

After Care

Time off work depends on the type of work as well as the surgical procedures performed. . A patient will be required to be non-weight bearing in a cast or splint and use crutches for four to twelve weeks. Usually a patient can return to work in one to two weeks if they are able to work while seated. If a person's job requires standing and walking, return to work may take several weeks. Complete recovery may take six months to a full year. Complications can occur as with all surgeries, but are minimized by strictly following your surgeon's post-operative instructions. The main complications include infection, bone that is slow to heal or does not heal, progression or reoccurrence of deformity, a stiff foot, and the need for further surgery. Many of the above complications can be avoided by only putting weight on the operative foot when allowed by your surgeon.
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Do You Really Understand Heel Soreness?

Overview

Feet Pain

Heel pain is one of the most common conditions to affect the foot. It is usually felt as an intense pain when the affected heel is used. The pain is usually worse when you get out of bed in the morning or after a long period of activity. In most cases, only one heel is affected. After walking, the pain usually improves. However, it is common for it to be painful when you first take a step after a period of rest. The pain often worsens by the end of the day. Most cases of heel pain are caused by damage and thickening of the plantar fascia. Sometimes, the surrounding tissue and the heel bone also become inflamed (swollen).

Causes

One of the most common heel pain causes is a condition called plantar fasciitis. The tendons, ligaments, muscles, and joints in the feet all work together to allow you to move your feet to walk or run. When the plantar fascia, or the arch of the foot, is overused or injured, pain is felt in the heel. The most common heel pain causes include plantar fasciitis, Achilles tendonitis, Bursitis, Fibromyalgia, Bone fracture, Heel spurs, Arthritis, Tarsal tunnel syndrome, Sever?s Disease.

Symptoms

The symptoms of plantar fasciitis are pain on the bottom of the heel, pain in the arch of the foot, pain that is usually worse upon arising, pain that increases over a period of months. People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they?ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.

Diagnosis

After you have described your foot symptoms, your doctor will want to know more details about your pain, your medical history and lifestyle, including. Whether your pain is worse at specific times of the day or after specific activities. Any recent injury to the area. Your medical and orthopedic history, especially any history of diabetes, arthritis or injury to your foot or leg. Your age and occupation. Your recreational activities, including sports and exercise programs. The type of shoes you usually wear, how well they fit, and how frequently you buy a new pair. Your doctor will examine you, including. An evaluation of your gait. While you are barefoot, your doctor will ask you to stand still and to walk in order to evaluate how your foot moves as you walk. An examination of your feet. Your doctor may compare your feet for any differences between them. Then your doctor may examine your painful foot for signs of tenderness, swelling, discoloration, muscle weakness and decreased range of motion. A neurological examination. The nerves and muscles may be evaluated by checking strength, sensation and reflexes. In addition to examining you, your health care professional may want to examine your shoes. Signs of excessive wear in certain parts of a shoe can provide valuable clues to problems in the way you walk and poor bone alignment. Depending on the results of your physical examination, you may need foot X-rays or other diagnostic tests.

Non Surgical Treatment

Treatment for heel pain usually involves using a combination of techniques, such as stretches and painkillers, to relieve pain and speed up recovery. Most cases of heel pain get better within 12 months. Surgery may be recommended as a last resort if your symptoms don't improve after this time. Only 1 in 20 people with heel pain will need surgery. Whenever possible, rest the affected foot by not walking long distances and standing for long periods. However, you should regularly stretch your feet and calves using exercises such as those described. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be used to help relieve pain. Some people also find applying an ice pack to the affected heel for 5-10 minutes can help relieve pain and inflammation. However, do not apply an ice pack directly to your skin. Instead, wrap it in a towel. If you do not have an ice pack, you can use a packet of frozen vegetables. Exercises designed to stretch both your calf muscles and your plantar fascia (the band of tissue that runs under the sole of your foot) should help relieve pain and improve flexibility in the affected foot. A number of stretching exercises are described below. It's usually recommended that you do the exercises on both legs, even if only one of your heels is affected by pain. This will improve your balance and stability, and help relieve heel pain. Keep a long towel beside your bed. Before you get out of bed in the morning, loop the towel around your foot and use it to pull your toes towards your body, while keeping your knee straight. Repeat three times on each foot. Place both hands on a wall at shoulder height, with one of your feet in front of the other. The front foot should be about 30cm (12 inches) away from the wall. With your front knee bent and your back leg straight, lean towards the wall until you feel a tightening in the calf muscles of your back leg. Then relax. Repeat this exercise 10 times before switching legs and repeating the cycle. You should practise wall stretches twice a day. Stand on a step of your stairs facing upstairs, using your banister for support. Your feet should be slightly apart, with your heels hanging off the back of the step. Lower your heels until you feel a tightening in your calves. Hold this position for about 40 seconds, before raising your heels back to the starting position. Repeat this procedure six times, at least twice a day. Sit on a chair, with your knees bent at right angles. Turn your feet sideways so your heels are touching and your toes are pointing in opposite directions. Lift the toes of the affected foot upwards, while keeping the heel firmly on the floor. You should feel your calf muscles and Achilles tendon (the band of tissue that connects your heel bone to your calf muscle) tighten. Hold this position for several seconds and then relax. Repeat this procedure 10 times, five to six times a day. While seated, roll the arch of your foot (the curved bottom part of the foot between your toes and heel) over a round object, such as a rolling pin, tennis ball or drinks can. Some people find that using a chilled can from their fridge has the added benefit of helping to relieve pain. Move your foot and ankle in all directions over the object for several minutes. Repeat the exercise twice a day. Your GP or podiatrist may advise you to change your footwear. You should avoid wearing flat-soled shoes, because they will not provide your heel with support and could make your heel pain worse. Ideally, you should wear shoes that cushion your heels and provide a good level of support to the arches of your feet. For women wearing high heels, and for men wearing heeled boots or brogues, can provide short- to medium-term pain relief, as they help reduce pressure on the heels. However, these types of shoes may not be suitable in the long term, because they can lead to further episodes of heel pain. Your GP or podiatrist can advise on footwear. Orthoses are insoles that fit inside your shoe to support your foot and help your heel recover. You can buy orthoses off-the-shelf from sports shops and larger pharmacies. Alternatively, your podiatrist should be able to recommend a supplier. If your pain does not respond to treatment and keeps recurring, or if you have an abnormal foot shape or structure, custom-made orthoses are available. These are specifically made to fit the shape of your feet. However, there is currently no evidence to suggest that custom-made orthoses are more effective than those bought off-the-shelf. An alternative to using orthoses is to have your heel strapped with sports strapping (zinc oxide) tape, which helps relieve pressure on your heel. Your GP or podiatrist can teach you how to apply the tape yourself. In some cases, night splints can also be useful. Most people sleep with their toes pointing down, which means tissue inside the heel is squeezed together. Night splints, which look like boots, are designed to keep your toes and feet pointing up while you are asleep. This will stretch both your Achilles tendon and your plantar fascia, which should help speed up your recovery time. Night splints are usually only available from specialist shops and online retailers. Again, your podiatrist should be able to recommend a supplier. If treatment hasn't helped relieve your painful symptoms, your GP may recommend corticosteroid injections. Corticosteroids are a type of medication that have a powerful anti-inflammatory effect. They have to be used sparingly because overuse can cause serious side effects, such as weight gain and high blood pressure (hypertension). As a result, it is usually recommended that no more than three corticosteroid injections are given within a year in any part of the body. Before having a corticosteroid injection, a local anaesthetic may be used to numb your foot so you don't feel any pain.

Surgical Treatment

When a diagnosis of plantar fasciitis is made early, most patients respond to conservative treatment and don?t require surgical intervention. Often, when there is a secondary diagnosis contributing to your pain, such as an entrapped nerve, and you are non-responsive to conservative care, surgery may be considered. Dr. Talarico will discuss all options and which approach would be the most beneficial for your condition.

heel spur surgery

Prevention

Foot Pain

Wear properly fitting shoes. Place insoles or inserts in your shoes to help control abnormal foot motion. Maintain a healthy weight. Exercise and do foot stretches as they have been shown to decrease the incidence of heel pain.
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Leg Length Discrepancy Running Symptoms

Overview

In growing children, legs can be made equal or nearly equal in length with a relatively simple surgical procedure. This procedure slows down the growth of the longer leg at one or two growth sites. Your physician can tell you how much equalization can be gained by this procedure. The procedure is performed under X-ray control through very small incisions in the knee area. This procedure will not cause an immediate correction in length. Instead, the limb length discrepancy will gradually decrease as the opposite extremity continues to grow and "catch up." Timing of the procedure is critical. The goal is to reach equal leg length by the time growth normally ends. This is usually in the mid-to-late teenage years. Disadvantages of this option include the possibility of slight over-correction or under-correction of the limb length discrepancy. In addition, the patient's adult height will be less than if the shorter leg had been lengthened. Correction of significant limb length discrepancy by this method may make a patient's body look slightly disproportionate because of the shorter leg. In some cases the longer leg can be shortened, but a major shortening may weaken the muscles of the leg. In the thighbone (femur), a maximum of 3 inches can be shortened. In the shinbone, a maximum of 2 inches can be shortened.Leg Length Discrepancy

Causes

LLDs are very common. Sometimes the cause isn?t known. But the known causes of LLD in children include, injury or infection that slows growth of one leg bone. Injury to the growth plate (a soft part of a long bone that allows the bone to grow). Growth plate injury can slow bone growth in that leg. Fracture to a leg bone that causes overgrowth of the bone as it heals. A congenital (present at birth) problem (one whole side of the child?s body may be larger than the other side). Conditions that affect muscles and nerves, such as polio.

Symptoms

Patients with significant lower limb length discrepancies may walk with a limp, have the appearance of a curved spine (non-structural scoliosis), and experience back pain or fatigue. In addition, clothes may not fit right.

Diagnosis

A doctor will generally take a detailed medical history of both the patient and family, including asking about recent injuries or illnesses. He or she will carefully examine the patient, observing how he or she moves and stands. If necessary, an orthopedic surgeon will order X-ray, bone age determinations and computed tomography (CT) scans or magnetic resonance imaging (MRI).

Non Surgical Treatment

To begin a path torwards a balanced foundation and reduce pain from leg length discrepancy, ask your doctor about these Functional Orthotics and procedures. Functional Orthotics have been shown to specifically reduce pain from leg length inequality, support all three arches of the foot to create a balanced foundation, maximize shock absorption, add extra propulsion, and supply more stability, enable posture correction and long-term preventive protection. Will improve prolonged effectiveness of chiropractic adjustments. Shoe or heel Lifts, Correct the deficiencies that causes imbalances in the body.

LLD Shoe Inserts

what is a heel raise?

Surgical Treatment

Large leg length inequalities can be treated by staged lengthenings or by simultaneous ipsilateral femoral and tibial lengthenings. Additionally, lengthenings can be combined with appropriately timed epiphysiodesis in an effort to produce leg length equality. Staged lengthenings are often used for congenital deficiencies such as fibular hemimelia, in which 15 cm or more may be needed to produce leg length equality. We typically plan for the final lengthening to be completed by age 13 or 14 years, and allow at least 3 years between lengthenings. Lengthening of both the tibia and femur simultaneously requires aggressive therapy and treatment of soft tissue contractures. Curran et al[57] reported the need for surgical release of soft tissue contractures in 3 of 8 patients treated with simultaneous ipsilateral femoral and tibial lengthenings. Lengthening over an IM nail can be done in an effort to decrease the amount of time the fixator needs to be worn and to prevent angular malalignment. This technique requires that the patient be skeletally mature and it carries a higher risk of osteomyelitis (up to 15%). Additionally, if premature consolidation occurs, a repeat corticotomy is more difficult.
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Mortons Neuroma Treatments

Overview

Morton neuromaMorton's neuroma is a swollen or thickened nerve in the ball of your foot. When your toes are squeezed together too often and for too long, the nerve that runs between your toes can swell and get thicker. This swelling can make it painful when you walk on that foot. High-heeled, tight, or narrow shoes can make pain worse. Sometimes, changing to shoes that give your toes more room can help.

Causes

The exact cause is as yet unclear. However there are a number of theories. Some expert s believe problems with the design of the foot makes some people more prone to Morton?s neuroma. Having flat feet or a high arch for example encourages the foot to slide forwards which can put excess pressure on the metatarsals. Bunions and hammer toes also increase the likelihood of developing Morton?s. However simply wearing high heels or any form of tight shoes that put pressure on the bones in the feet can also lead to a Morton?s . Typically the condition comes on between the age of 40 and 50. It is far more common in women than men - three out of four sufferers are women.

Symptoms

You may initially experience a tingling sensation in the space between your toes, which gets worse over time. This leads to cramp in your toes and a sharp shooting or burning pain on the ball of your foot or at the base of your toes. The pain is often worse when walking or wearing shoes that press on the affected area. This is caused by irritation of the nerve between your toe bones (metatarsal bones). The tingling will eventually lead to pain, which can get worse over time. You may also experience cramping of your toes. The pain is usually felt as a sharp shooting or burning pain on the ball of the foot or at the base of the toes, which is often made worse when you're walking. Some people with Morton's neuroma feel anxious about walking or even placing their foot on the ground. The pain is likely to be more intense if you wear tight shoes, so wearing shoes that have more room in the toe area can help. Rubbing your foot may also lessen the pain.

Diagnosis

There is a special orthopedic test called the Morton's test that is often used to evaluate the likelihood of plantar nerve compression. For this test, the client is supine on the treatment table. The practitioner grasps the client's forefoot from both sides and applies moderate pressure, squeezing the metatarsal heads together. If this action reproduces the client's symptoms (primarily sharp, shooting pain into the toes, especially the third and fourth), Morton's neuroma may exist.

Non Surgical Treatment

There are various options for treating the condition, depending on its severity. Self-treatment. Here are some simple steps that may improve symptoms. Wear supportive shoes with a wide toe box. Do not lace the forefoot of the shoe too tightly. Shoes with shock-absorbent soles and proper insoles are recommended. Do not wear tight or pointed toed shoes or shoes with heels more than 2 inches high. Use over-the-counter shoe pads to relieve pressure. Apply an ice pack to the affected area to reduce pain and swelling. Rest your feet and massage the painful area. There are drugs that may temporarily relieve the pain and other symptoms of Morton?s neuroma. Long-term use of these medications is not recommended. Anti-inflammatory drugs-Nonsteroidal anti-inflammatory drugs, such as ibuprofen or aspirin, may be taken orally to reduce pain and inflammation. Anti-inflammatory drugs can also be administered by direct injection into the skin. Local anesthetic. An anesthetic injection will temporarily relieve pain by numbing the affected nerve. Orthotics. These are custom-designed shoe inserts that can reduce some of the pain associated with Morton?s neuroma. Sometimes padding is placed around the toe area, and tape is applied to hold the padding in place.intermetatarsal neuroma

Surgical Treatment

If conservative treatment does not relieve your symptoms, your orthopaedic surgeon may discuss surgical treatment options with you. Surgery can resect a small portion of the nerve or release the tissue around the nerve, and generally involves a short recovery period.
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Podiatrists Prefer Shoe Lifts For Leg Length Difference

There are actually two different types of leg length discrepancies, congenital and acquired. Congenital indicates you are born with it. One leg is anatomically shorter compared to the other. As a result of developmental stages of aging, the brain picks up on the gait pattern and identifies some variance. The human body usually adapts by dipping one shoulder over to the "short" side. A difference of under a quarter inch is not very irregular, does not need Shoe Lifts to compensate and normally won't have a serious effect over a lifetime.

Leg Length Discrepancy Shoe Lifts

Leg length inequality goes typically undiagnosed on a daily basis, however this problem is easily solved, and can eradicate numerous cases of back pain.

Treatment for leg length inequality commonly consists of Shoe Lifts. These are affordable, regularly being less than twenty dollars, compared to a custom orthotic of $200 if not more. When the amount of leg length inequality begins to exceed half an inch, a whole sole lift is generally the better choice than a heel lift. This prevents the foot from being unnecessarily stressed in an abnormal position.

Lumbar pain is the most widespread condition impacting people today. Over 80 million people experience back pain at some stage in their life. It is a problem that costs businesses vast amounts of money annually as a result of lost time and output. Innovative and superior treatment solutions are continually sought after in the hope of decreasing the economical impact this issue causes.

Leg Length Discrepancy Shoe Lift

People from all corners of the earth suffer from foot ache due to leg length discrepancy. In most of these cases Shoe Lifts can be of very beneficial. The lifts are capable of decreasing any pain and discomfort in the feet. Shoe Lifts are recommended by many specialist orthopaedic physicians.

In order to support the body in a nicely balanced fashion, your feet have a critical task to play. Inspite of that, it can be the most neglected region in the body. Many people have flat-feet which means there is unequal force placed on the feet. This causes other parts of the body like knees, ankles and backs to be affected too. Shoe Lifts make sure that correct posture and balance are restored.

Hammer Toe Relief

HammertoeOverview

A Hammer toe is a toe that tends to remain bent at the middle joint in a claw-like position. There are 2 types of hammer toe. Flexible hammer toe, can be straightened by hand. Rigid hammer toe, cannot be pulled straight and can be extremely painful. The position of the toe can also lead to corns or calluses. These may also be painful. Hammer toe may be present at birth or develop later in life due to tendons that have tightened, causing the toe's joints to curl downward. Occasionally, all toes may be bent. This may be due to problems with the peripheral nerves or the spinal cord.

Causes

Your toe contains two joints that allow it to bend at the middle and bottom. A hammertoe occurs when the middle joint becomes dislocated. Common causes of this joint dislocation include a toe injury, arthritis, a high foot arch, wearing shoes that don?t fit properly, tightened ligaments or tendons in the foot, pressure from a bunion (when your big toe points inward toward your second toe) Spinal cord or peripheral nerve damage may cause all of your toes to curl downward.

HammertoeSymptoms

Here is a look at some of the symptoms hammertoe can cause. They include hammer-like or claw-like appearance of the toe. Pain when walking or moving the foot. Difficulty moving the toe. Corns may form on top of the toe. Callus may form on the sole of the foot. During the initial stages, you may be able to manually straighten your toe. This is called a flexible hammertoe. But as time passes, the toe will not move as easily and will continue to look like a hammer. Pressure and irritation over the joint can cause a blister to develop and become a Hammer toes corn over time. These corns have the potential to become infected and cause additional symptoms such as redness, bleeding, and difficulty wearing shoes and socks. Corns are the main cause of pain when hammertoes are developing.

Diagnosis

First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.

Non Surgical Treatment

If the affected toe is still flexible, you may be able to treat it by taping or splinting the toe to hold it straight. Your family doctor can show you how to do this. You may also try corrective footwear, corn pads and other devices to reduce pain. You may need to do certain exercises to keep your toe joints flexible. For example, you may need to move and stretch your toe gently with your hands. You can also exercise by picking things up with your toes. Small or soft objects, such as marbles or towels, work best. If your hammer toe becomes painful, you may need to apply an ice pack several times a day. This can help relieve the soreness and swelling. Nonsteroidal anti-inflammatory medicines (also called NSAIDs), such as ibuprofen (two brand names: Advil, Motrin) or naproxen (one brand name: Aleve), may be helpful. If your pain and swelling are severe, your doctor may need to give you a steroid injection in the toe joint.

Surgical Treatment

Laser surgery is popular for cosmetic procedures, however, for hammer toe surgery it does not offer any advantage to traditional methods. Laser is useful for soft tissues (not bone), and because hammer toe surgery involves bone procedures, it is not effective. For cosmetic hammer toe surgery, patients should look for surgeons experienced in aesthetic foot surgery.
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How To Correct Hammer Toes

HammertoeOverview
The 2nd toe is the most common digit to develop a Hammer Toe deformity. Second toe hammer toes commonly result from an elongated 2nd metatarsal and from pressure due to an excessively abducted great toe (hallux valgus deformity) causing a bunion. Unusually long toes often develop hammer toe deformities. Painful corns often develop in hammer toe deformity, particularly of the 5th toe. Reactive adventitial bursas often develop beneath corns, which may become inflamed.

Causes
Hammertoes are usually structural in nature. Many times this is the foot structure you were born with and other factors have now made it so that symptoms appear. The muscles in your foot may become unbalanced over time, allowing for a deformity of the small bones in each toe. With longstanding deformity the toe may become rigid. Sometimes one toe is longer than another and this causes a buckling of the digit. A hammertoe may also be caused by other foot deformities such as a bunion. Trauma or other surgery of your foot may predispose you to having the condition if your foot structure is altered. Hammer Toe

Symptoms
Symptoms of a hammertoe are usually first noticed as a corn on the top of the toe or at the tip which produces pain with walking or wearing tight shoes. Most people feel a corn is due to a skin problem on their toes, which in fact, it is protecting the underlying bone deformity. A corn on the toe is sometimes referred to as a heloma dura or heloma durum, meaning hard corn. This is most common at the level of the affected joint due to continuous friction of the deformity against your shoes.

Diagnosis
Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe.

Non Surgical Treatment
The most common treatment is to wear more comfortable shoes. When choosing a shoe, make sure the toe area is high and broad and has enough room for hammer toes. If there is chronic pain, surgery may be needed to correct a malalignment. Surgical treatments are aimed at loosening up the contracted toe joints to allow them to align properly. Other types of treatment are products designed to relieve hammer toes, such as hammer toe crests and hammer toe splints. These devices will help hold down the hammer toe and provide relief to the forefoot. Gel toe shields and gel toe caps can also be used. Gel toe shields and toe caps will help eliminate friction between the shoe and the toe, while providing comfort and lubrication.

Surgical Treatment
As previously mentioned it?s best to catch this problem early; hammer toe taping is relatively harmless and simple. Long term complications can cause foot deformities and even difficulty walking. It?s always best to stiff shoes and high heel, especially if you?re working on hammer toe recovery. Pick comfortable shoes with plenty of toe space. Prevention is the best cure here as this injury is nearly always self inflicted. Hammer Toe

Prevention
In some cases foot problems may present at birth, many foot problems such as hammer toes can be prevented. Hammer toe prevention can be a simple process, such as, checking your feet regularly and wearing the right shoes for your feet. Good circulation is also an essential part of foot health and hammer toe prevention. Taking a warm foot bath or giving yourself a foot massage are great ways of keeping your feet healthy.

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