A hammertoes is a toe that is bent because of a muscle imbalance around the toe joints. The imbalance causes the toe to bend at one or more joints, pushing the middle of hammertoe the toe upward in a claw-like position. If you notice such changes, it is important to seek proper treatment. Hammer toes never get better without some type of intervention and the sooner it is treated, the better the outcome.
If a foot is flat (pes planus, pronated), the flexor muscles on the bottom of the foot can overpower the others because a flatfoot is longer than a foot with a normal arch. When the foot flattens and lengthens, greater than normal tension is exerted on the flexor muscles in the toes. The toes are not strong enough to resist this tension and they may be overpowered, resulting in a contracture of the toe, or a bending down of the toe at the first toe joint (the proximal interphalangeal joint) which results in a hammertoe. If a foot has a high arch (pes cavus, supinated), the extensor muscles on the top of the foot can overpower the muscles on the bottom of the foot because the high arch weakens the flexor muscles. This allows the extensor muscles to exert greater than normal tension on the toes. The toes are not strong enough to resist this tension and they may be overpowered, resulting in a contracture of the toe, or a bending down of the toe at the first toe joint (the proximal interphalangeal joint) which results in a hammertoe.
Common reasons patients seek treatment for toe problems are toe pain on the knuckle. Thick toe calluses. Interference with walking/activities. Difficulty fitting shoes. Worsening toe deformity. Pain at the ball of the foot. Unsightly appearance. Toe deformities (contractures) come in varying degrees of severity, from slight to severe. The can be present in conjunction with a bunion, and develop onto a severe disfiguring foot deformity. Advanced cases, the toe can dislocate on top of the foot. Depending on your overall health, symptoms and severity of the hammer toe, the condition may be treated conservatively and/or with surgery.
Some questions your doctor may ask of you include, when did you first begin having foot problems? How much pain are your feet or toes causing you? Where is the pain located? What, if anything, seems to improve your symptoms? What, if anything, appears to worsen your symptoms? What kind of shoes do you normally wear? Your doctor can diagnose hammertoe or mallet toe by examining your foot. Your doctor may also order X-rays to further evaluate the bones and joints of your feet and toes.
Non Surgical Treatment
Conservative treatment starts with new shoes that have soft, roomy toe boxes. Shoes should be one-half inch longer than your longest toe. (Note: For many people, the second toe is longer than the big toe.) Avoid wearing tight, narrow, high-heeled shoes. You may also be able to find a shoe with a deep toe box that accommodates the hammer toe. Or, a shoe specialist (Pedorthist) may be able to stretch the toe box so that it bulges out around the toe. Sandals may help, as long as they do not pinch or rub other areas of the foot.
There are generally two methods surgeons use to correct hammer toes, they are joint resection (arthroplasty) or bone mending (fusion), and the location where this is performed on the toe depends on where the toe is buckled. Its important to recognize that most of the surgical work involved the joints of the toe, not the joint of the ball of the foot. Sometimes a toe relocation procedure is needed when the joint of the ball of the foot is malaligned (subluxed or dislocated).
There are several things you can do to help prevent hammer toes from forming or progressing. Wear supportive shoes to help prevent deformities. Hammer toes are often related to faulty foot mechanics, especially foot flattening. Wear custom orthotics prescribed by your podiatrist. Orthotics may slow the progression or prevent the development of hammer toes. Avoid shoes with narrow or pointed toe boxes that can compress the toes.
More than one-third of women in America have bunions, a common deformity often blamed on wearing tight, narrow shoes and high heels. Bunions may occur in families, but many are from wearing tight shoes, and nine out of 10 bunions happen to women. Too-tight shoes can also cause other disabling foot problems such as corns, calluses and hammer toes.
There is no single cause of hallux valgus. It most commonly runs in families but may skip generations. High heel, pointed toe shoes are not the primary cause of the hallux valgus but they do cause it to be painful. Pressure from shoes may cause bunions, corns and calluses to develop where there is hallux valgus deformity.
Alteration in alignment of the first toe. Pain in the 1st toe joint with movement. Restriction in range of demi pointe. Inflammation of the 1st toe joint. Rotation of the big toe so that the nail no longer faces upwards. Occasionally bruising of the toe nail occurs.
Diagnosis begins with a careful history and physical examination by your doctor. This will usually include a discussion about shoe wear and the importance of shoes in the development and treatment of the condition. X-rays will probably be suggested. This allows your doctor to measure several important angles made by the bones of the feet to help determine the appropriate treatment.
Non Surgical Treatment
Fortunately, many bunions never go on to cause problems other than the cosmetic appearance. The easiest option is to try different shoes or padding, however this is not the answer for everyone. The various straps and braces that are commercially available are not proven to be particularly effective.
The surgical treatment will vary depending on x-ray analysis and severity of the deformity. Most bunion surgeries focus on realigning the bony deformities of the bunion/big toe joint. At Accent on Feet we practice Ambulatory foot surgery for bunion correction. This method allows for faster healing, lower risk and preferred cosmetic result over traditional hospital surgery. All surgical procedures are performed in the office using local anesthesia (freezing). All patients walk immediately.
The best protection against developing bunions is to protect and care for your feet every day. Avoid tight and narrow-fitting shoes. Limit your use of high heels. Wear comfortable shoes with adequate space between your longest toe and the end of the shoe. Getting treatment for very flat or very high-arched feet (if you are experiencing symptoms) will give your feet the proper support and help maintain stability and balance.
The Achilles tendon is the largest tendon in the body; connecting the calf muscles to the heel. An Achilles tendon rupture prevents the tendon from performing its function of pulling the foot and ankle downward during walking, running and jumping. Most ruptures occur about four to six inches above the heel, but the tendon can also tear where it meets the heel bone.
There are a number of factors that can increase the risk of an Achilles tendon rupture, which include the following. You?re most likely to rupture your Achilles tendon during sports that involve bursts of jumping, pivoting and running, such as football or tennis. Your Achilles tendon becomes less flexible and less able to absorb repeated stresses, for example of running, as you get older. Small tears can develop in the fibres of the tendon and it may eventually completely tear. There is a very small risk of an Achilles tendon rupture if you have Achilles tendinopathy (also called Achilles tendinitis). This is where your tendon breaks down, which causes pain and stiffness in your Achilles tendon, both when you exercise and afterwards. If you take quinolone antibiotics and corticosteroid medicines, it can increase your risk of an Achilles tendon injury, particularly if you take them together. The exact reasons for this aren't fully understood at present.
Symptoms of an Achilles tendon rupture include sensation that someone or something has hit the back of the calf muscle, sudden pain, pain when walking, weakness in the leg, which is particularly noticeable when trying to push off while walking and there is not sufficient strength to do so.
During the physical exam, your doctor will inspect your lower leg for tenderness and swelling. In many cases, doctors can feel a gap in your tendon if it has ruptured completely. The doctor may also ask you to kneel on a chair or lie on your stomach with your feet hanging over the end of the exam table. He or she may then squeeze your calf muscle to see if your foot will automatically flex. If it doesn't, you probably have ruptured your Achilles tendon. If there's a question about the extent of your Achilles tendon injury, whether it's completely or only partially ruptured, your doctor may order an ultrasound or MRI scan. These painless procedures create images of the tissues of your body.
Non Surgical Treatment
There are two treatment options available which are non-operative and operative. Non-operative treatment involves the use initially of a below-knee plaster with the foot held fully bent downwards. This usually stays in place for 2 weeks then is changed for a brace(this is a boot from the knee down to the toes with Velcro straps) which should be worn day and night. The brace will be regularly altered to allow the foot to come up to a more neutral position. The brace will be on for a further 6 weeks. After the 8 weeks you will be referred for physiotherapy to regain movement and calf strength but will probably need to wear the brace during the day for a further 4 weeks. Non-operative treatment avoids the risks of surgery but the risk of the tendon re-rupturing, which normally occurs within 3 months of discarding the brace, is 10%.
A completely ruptured Achilles tendon requires surgery and up to 12 weeks in a cast. Partial tears are sometimes are treated with surgery following by a cast. Because the tendon shortens as it heals, a heel lift is used for 6 months or more after the cast comes off. Physical therapy to regain flexibility and then strength are begun as soon as the cast is off.
Customizing your website is easy. Just login and point your mouse at any content block on the page and an editor will come up allowing you to change or delete it.
To add more content, change your theme, or access other features, explore the toolbar at the top of the page.