Archives for the month of: June, 2015

Hammer ToeOverview

Hammer toes is a secondary problem originating from fallen cross arches. The toes start to curl and get pulled backwards, as the collapsed or pushed out metatarsal bones pull the tendons and ligaments, and causes them to get shorter and tighter. This condition causes the toes have higher pressure and they have limited movement and cannot be straightened fully. This can lead to numbness and pain in the toes as muscles, nerves, joints and little ligaments are involved with this condition. As the top part of the toe can rub against the shoe, it can cause corns and calluses.

Causes

It is possible to be born with a hammer toe, however many people develop the deformity later in life. Common causes include tightened tendons that Hammer toes cause the toe to curl downward. Nerve injuries or problems with the spinal cord. Stubbing, jamming or breaking a toe. Having a stroke. Being a diabetic. Having a second toe that is longer than the big toe. Wearing high heels or tight shoes that crowd the toes and don?t allow them to lie flat. Aging.

HammertoeSymptoms

Hammertoe and mallet toe feature an abnormal bend in the joints of one or more of your toes. Moving the affected toe may be difficult or painful. Corns and calluses can result from the toe rubbing against the inside of your shoes. See your doctor if you have persistent foot pain that affects your ability to walk properly.

Diagnosis

Your healthcare provider will examine your foot, checking for redness, swelling, corns, and calluses. Your provider will also measure the flexibility of your toes and test how much feeling you have in your toes. You may have blood tests to check for arthritis, diabetes, and infection.

Non Surgical Treatment

Inserts in your shoes can be used to help relieve pressure on the toes from the deformity. Splints/Straps. These can be used to help re-align and stretch your toes and correct the muscle imbalance and tendon shortening. One of the most common types are toe stretchers like the yogatoe. Chiropody. A chiropodist can remove calluses or corns, areas of hard skin that have formed to make the foot more comfortable.Steroid injections can help to reduce pain and inflammation.

Surgical Treatment

Ordinary hammertoe procedures often use exposed wires which extend outside the end of toes for 4-6 weeks. Common problems associated with wires include infection where the wires come out of the toe, breakage, pain from hitting the wire, and lack of rotational stability causing the toe to look crooked. In addition, wires require a second in-office procedure to remove them, which can cause a lot of anxiety for many patients. Once inserted, implants remain within the bone, correcting the pain and deformity of hammertoes while eliminating many of the complications specific traditional treatments.

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HammertoeOverview

Hammer toe, also called hammer toe, deformity of the second, third, or fourth toe in which the toe is bent downward at the middle joint (the proximal interphalangeal [PIP] joint), such that the overall shape of the toe resembles a hammer. Most cases of hammertoe involve the second toe, and often only one or two toes are affected. In rare cases when all the toes are involved, a thorough neurological assessment is necessary to evaluate for underlying nerve or spinal cord problems.

Causes

The muscles of each toe work in pairs. When the toe muscles get out of balance, a hammertoe can form. Muscle imbalance puts a lot of pressure on the toe’s tendons and joints. This pressure forces the toe into a hammerhead shape. How do the toe muscles get out of balance? There are three main reasons. Genes. you may have inherited a tendency to develop hammertoes because your feet are somewhat unstable, they may be flat or have a high arch. Arthritis. Injury to the toe, ill-fitting shoes are the main culprits. If shoes are too tight, too short, or too pointy, they push the toes out of balance. Pointy, high-heeled shoes put particularly severe pressure on the toes.

Hammer ToeSymptoms

Signs and symptoms of hammertoe and mallet toe may include a hammer-like or claw-like appearance of a toe. In mallet toe, a deformity at the end of the toe, giving the toe a mallet-like appearance. Pain and difficulty moving the toe. Corns and calluses resulting from the toe rubbing against the inside of your footwear. Both hammertoe and mallet toe can cause pain with walking and other foot movements.

Diagnosis

The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe points in the opposite direction (plantar flexed). Toes may appear crooked or rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at the tip of the affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still flexible or not. It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the involved joints, as well as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.

Non Surgical Treatment

Your podiatrist may recommend one or more of these treatments to manage your hammer toes. Wear shoes with roomy toe boxes which don?t force your toes together. Exercises hammertoes to stretch and strengthen muscles in the toes. Over the counter toe straps, cushions, and corn pads. Custom orthotic inserts. Toe caps or toe slings. In severe cases, surgery to release the muscles in the affected toes.

Surgical Treatment

If these treatments are not sufficient at correcting the hammer toe, an operation to straighten the toe may be necessary. This is often performed in conjunction with surgery for a bunion deformity. The surgical treatment of a hammer toe can consist of either cutting the tendons to relieve the pressure that causes the deformity, or fusing the toe so that it points straight permanently.

Overview

Simply put, over-pronation is an excessive or poorly timed pronation which is part of the regular stride. Pronation is when the foot rolls inwards and the arch compresses as part of your normal walking motion. Pronation is necessary for shock absorption to transmit forces up and down our legs. When someone over-pronates, the foot rolls inwards to a greater degree and the arch flattens: this causes the knee and hip to come out of alignment and reduces the function of all the bones in the feet.Foot Pronation

Causes

Generally fallen arches are a condition inherited from one or both parents. In addition, age, obesity, and pregnancy cause our arches to collapse. Being in a job that requires long hours of standing and/or walking (e.g. teaching, retail, hospitality, building etc) contributes to this condition, especially when standing on hard surfaces like concrete floors. Last, but not least unsupportive footwear makes our feet roll in more than they should.

Symptoms

Due to the laxity of the soft tissue structures of the foot, and the fact that the joints are not held together properly, the bones of the feet shift. When this occurs, the muscles that attach to these bones must also shift, or twist, in order to attach to these bones. The strongest and most important muscles that attach to our foot bones come from our lower leg. So, as these muscles course down the leg and across the ankle, they must twist to maintain their proper attachments in the foot. This twisting of these muscles will cause shin splints, Achilles Tendonitis, generalized tendonitis, fatigue, muscle aches and pains, cramps, ankle sprains, and loss of muscular efficiency (reducing walking and running speed and endurance). The problems we see in the feet, which are due to over-pronation include bunions, heel spurs, plantar fasciitis, fallen and painful arches, hammertoes, metatarsalgia (ball of foot pain), and calluses.

Diagnosis

People who overpronate have flat feet or collapsed arches. You can tell whether you overpronate by wetting your feet and standing on a dry, flat surface. If your footprint looks complete, you probably overpronate. Another way to determine whether you have this condition is to simply look at your feet when you stand. If there is no arch on the innermost part of your sole, and it touches the floor, you likely overpronate. The only way to truly know for sure, however, is to be properly diagnosed by a foot and ankle specialist.Over-Pronation

Non Surgical Treatment

An orthotic is a device inserted inside the shoe to assist in prevention and/or rehabilitation of injury. Orthotics support the arch, prevent or correct functional deformities, and improve biomechanics. Prescription foot orthoses are foot orthoses which are fabricated utilizing a three dimensional representation of the plantar foot and are specifically constructed for an individual using both weightbearing and nonweightbearing measurement parameters and using the observation of the foot and lower extremity functioning during weightbearing activities. Non-prescription foot orthoses are foot which are fabricated in average sizes and shapes in an attempt to match the most prevalent sizes and shapes of feet within the population without utilizing a three dimensional representation of the plantar foot of the individual receiving the orthosis.

Prevention

Firstly, a thorough and correct warm up will help to prepare the muscles and tendons for any activity or sport. Without a proper warm up the muscles and tendons around your feet, ankles and lower legs will be tight and stiff. There will be limited blood flow to the lower legs, which will result in a lack of oxygen and nutrients for those muscles. Click here for a detailed explanation of how, why and when to perform your warm up. Secondly, flexible muscles are extremely important in the prevention of most ankle and lower leg injuries. When muscles and tendons are flexible and supple, they are able to move and perform without being over stretched. If however, your muscles and tendons are tight and stiff, it is quite easy for those muscles and tendons to be pushed beyond their natural range of motion. To keep your muscles and tendons flexible and supple, it is important to undertake a structured stretching routine.