Understanding Toe and Foot Deformities
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It is hard to define normal when it comes to feet, because so few of us have a perfect pair of them. Most of us have some genetic, structural, or biomechanical condition that affects how our feet look and behave. If you are one of the lucky ones with straight toes, neutral arches, and strong balanced muscles—be thankful. You do not have to suffer one of the common deformities that can make wearing shoes or walking difficult.
Toes Out of Shape
A few toe deformities are genetic. Underlapping or congenital curly toe (4th or 5th toe curves outward, with the tip lying under the adjacent toe) and overlapping toes (the pinky toe lies up and over the 4th toe) can run in families and are often present at birth. Others are due to an inherited foot structure or muscle imbalance and show up later. Bunions and hammertoes fall in this category.
Toe Joints That Go Bump
Because of your foot structure and how it moves when you walk, you may develop a bunion by your big toe. This condition is when the tip of the toe leans over toward the smaller toes, and the joint where it connects to your foot moves out in the opposite direction, causing a bump on the inner edge of your foot. This condition is often related to flat feet and overpronation. Because your foot rolls too far to the inside as you step, pressure on the big toe when you push off nudges it out of alignment. Shoes that are too tight can gradually cause the same pressure on the toe.
Bunions can be treated in the early stages by changing shoes or using orthotics that decrease pronation, wearing a night splint, or manipulating the toes and doing stretching exercises. Without these measures, and maybe even in spite of them, your toe may keep getting worse, until the bunion starts giving you pain and makes it difficult to walk. In the final stages, only corrective surgery may be able to relieve your symptoms and allow you to wear shoes and walk normally.
Toes That Curl Up
There are three types of small toe deformities named according to which joints are involved. They result from an imbalance in muscle strength (bottom ones are too tight, top ones too loose), tendons that are too short or stretched, or nerve damage that changes the way your toe functions.
With a hammertoe, the middle joint is bent up, so your toe looks like an upside-down V. This joint can rub against your shoes and develop a painful corn.
A mallet toe is straight except for the very end joint, which bends down. Friction from shoes can cause a callus on the tip.
With a claw toe, the two end joints are both curled, so the toe takes on a crescent shape. This means you can develop a callus on the tip as well as a painful corn on the middle joint.
Wearing roomy shoes, doing stretches to keep the joints limber the muscles balanced, and use of taping, padding, or orthotics are all conservative ways to treat curled toes and possibly head off the need for surgical correction.
Other Foot Deformities
Some children have club feet (turned in and down) when they are born. Conservative manipulation and casting usually allows the feet to develop normally. Metatarsus addictus (foot bones angled incorrectly) flexible or rigid flatfoot, and cavus foot (rigid, high arches) can also be present at birth, and will need monitoring and possible treatment.
Your joints can become deformed over time, as well, from conditions like rheumatoid arthritis, diabetes, and peripheral neuropathy. These can make it extremely painful to wear shoes and severely limit your mobility.
Catching many conditions early is the key to treating them conservatively without the use of surgery, which is always preferable. Whenever you notice changes in the shape or alignment of your foot, don’t wait until it worsens and you cannot walk without pain. Contact Lighthouse Foot and Ankle Center in Portland, ME, by calling (207) 774-0028 or requesting an appointment on our webpage. We want to help you conquer your foot problems so you can walk and enjoy life without pain.
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