Overview


Hammer toe affects both joints of a toe, causing the toe to bend upwards at the proximal joint (the joint closest to the foot) and down at the distal joint (the one farthest away from the foot). The resulting unnatural bend is often compared to an upside down "V" and also to a hammer or a claw (The condition is sometimes referred to as clawtoe or clawfoot). A similar condition, in which the first joint of a toe simply bends downward, is called mallet toe. Since the arched bending of hammertoe often causes the toe to rub against the top of the shoe's toe box and against the sole, painful corns and calluses develop on the toes. Hammertoe can also be a result of squeezing within a too-small or ill-fitting shoe or wearing high heels that jam your toes into a tight toe box inside your shoe, arthritis, trauma Hammer toes and muscle and nerve damage from diseases such as diabetes. Probably because of the tight-shoe and high-heel shoe factors, hammertoe tends to occur far more often in women than in men.


Causes


More often than not, wearing shoes that do not fit a person well for too long may actually cause hammer toes. Wearing shoes that are too narrow or too tight for the person for extended periods of time may eventually take a toll on the person's feet. The same is true for women who like wearing high-heeled shoes with narrow toe boxes.


Symptoms


A toe (usually the second digit, next to the big toe) bent at the middle joint and clenched into a painful, clawlike position. As the toe points downward, the middle joint may protrude upward. A toe with an end joint that curls under itself. Painful calluses or corns. Redness or a painful corn on top of the bent joint or at the tip of the affected toe, because of persistent rubbing against shoes Pain in the toes that interferes with walking, jogging, dancing, and other normal activities, possibly leading to gait changes.


Diagnosis


Your doctor is very likely to be able to diagnose your hammertoe simply by examining your foot. Even before that, he or she will probably ask about your family and personal medical history and evaluate your gait as you walk and the types of shoes you wear. You'll be asked about your symptoms, when they started and when they occur. You may also be asked to flex your toe so that your doctor can get an idea of your range of motion. He or she may order x-rays in order to better define your deformity.


Non Surgical Treatment


If the problem is caught in the early stages you can avoid hammer toe surgery. One of the easiest methods of treatment is to manipulate the toe out of a bent position then splint and buddy wrap it alongside it?s larger neighbour. This method of hammer toe taping will help the problem to fix itself. Make sure the toe isn?t resuming its bent shape during the recovery. To alleviate some of the painful symptoms of hammer toe avoid wearing high heels or shoes that cramp or stifle your feet. Choosing a pair of minimalist shoes can be an excellent choice for both foot and postural health. Wearing shoes that give the toes plenty of space and are comfortable lined is also a smart choice. Hammer toe recovery starts be treating the toe respectfully. Soft insoles or protection for the corn can also provide additional assistance.


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.


Prevention


elect and wear the right shoe for specific activities (such as running shoes for running). Alternate shoes. Don't wear the same pair of shoes every day. Avoid walking barefoot, which increases the risk for injury and infection. At the beach or when wearing sandals, always use sunblock on your feet, as you would on the rest of your body. Be cautious when using home remedies for foot ailments. Self-treatment can often turn a minor problem into a major one. It is critical that people with diabetes see a podiatric physician at least once a year for a checkup. People with diabetes, poor circulation, or heart problems should not treat their own feet, including toenails, because they are more prone to infection.

Overview


Toe problems and toe deformities such as claw toe and Hammer toe happen when the tendons (guiders) that move the toes get too tight or out of balance. The affected toe can rub on other toes and on the inside of your shoe, causing pressure and pain. Inflammatory arthritis, (swelling, pain, stiffness in joints), which, such as rheumatoid arthritis can damage the toe joints and this may make them come out of position (dislocate).


Causes


A hammertoe is formed due an abnormal balance of the muscles in the toes. This abnormal balance causes increased pressures on the tendons and joints of the toe, leading to its contracture. Heredity and trauma can Hammer toes also lead to the formation of a hammertoe. Arthritis is another factor, because the balance around the toe in people with arthritis is so disrupted that a hammertoe may develop. Wearing shoes that are too tight and cause the toes to squeeze can also be a cause for a hammertoe to form.


Symptoms


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 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


The earlier a hammertoe is diagnosed, the better the prognosis and treatment options. Your doctor will be able to diagnose your hammertoe with a simple examination of the foot and your footwear. He or she may take an x-ray to check the severity of the condition. You may also be asked about your symptoms, your normal daily activities, and your medical and family history.


Non Surgical Treatment


Hammertoes that are not painful (asymptomatic) and still flexible may not require treatment. In mild cases, open-toed, low-heeled, or wider shoes and foam or moleskin pads can provide symptomatic relief by reducing pressure. Taping (strapping) the affected toe can help to reduce deformity and pain. Physical therapy to instruct patients in exercises that passively stretch tight structures and strengthen weak foot intrinsic muscles is also helpful with mild cases. Periodic trimming (debridement) of corns (clavi, helomata) by a podiatrist can provide temporary relief. Corticosteroid injections are often very effective in reducing pain.


Surgical Treatment


he basis for hammer toe surgery most often involves removing s portion of bone within the toe, to reduce the joint contracture. Depending on the direction the toe is deviated, soft tissue procedures may be necessary along with pinning the toe with a surgical wire.

Overview

A bunion is a very common foot deformity that develops over the first metatarsal phalageal joint of the big toe of the foot. The joint that joins the big toe to the foot is called the first MTP joint. When it becomes prominent and the big toe starts to become crooked this is known as a bunion. The term referring to deformity of the big toe as it becomes crooked is called Hallux Valgus. It is the bump itself that is known as the bunion. When it gets red and swollen over the bunion because it gets sore this is usually due to an inflamed soft tissue over the underlying bone.

Causes
Despite the popular belief, wearing high heels and too-narrow shoes does not cause bunions. Wearing them can irritate, aggravate, or accelerate the formation of the bunion, but are not the root cause. Bunions are more commonly inherited, if your parents or grandparents had bunions, you may also get one. Bunions can also be caused by trauma or injury to the joints, ligaments, or bones of the foot.
SymptomsBunions may cause no pain at first. But as the big toe begins to turn in towards the other toes, people with bunions usually experience redness, pain, swelling, and tenderness in the area around the joint. Pressure inside the joint or from footwear pressing against the bunion may also cause discomfort. As the affected toe curves closer to the other toes on the foot, these toes can become painful as well. Complications of bunions include corns, calluses, hammer toe, and ingrown toenails. Other complications include irritation of the nerves surrounding the bunion area. Excess rubbing of the bunion against the footwear may lead to changes in the skin, resulting in corns or calluses. Hammer toe is a deformity of the toe immediately next to the big toe. A hammer toe is slightly raised and points upwards from the base and downwards at the end of the toe. Ingrown toenails can result from increased pressure from the big toe on the other toes. There may also be a decrease in the amount a person can move the joint affected by the bunion. Irritation of the nerves will feel like burning or decreased sensation.

Diagnosis
Most patients are diagnosed to have bunions from clinical history and examination. However, in some cases, X-rays will be performed to determine the extent of damage to the joint. Furthermore, it will enable the treating doctor to decide on the best course of management of the patient.

Non Surgical Treatment
There are two ways to treat this pathological foot conditions, conservatively and surgically. Conservative treatment is the first line treatment which consists of splints and orthotic care to reduce the causative factors. Realigning the foot with the aid of an orthotic helps prevent further degeneration and/or reduce symptoms of HAV in any stage of its deformity. Along with orthotic care, patients may require debridement of corns and calluses produced due to extra forces produced on the foot. Orthotics will also help the function of the big toe joint as it allows it to bend in the correct position. Footwear advice is also essential in the conservative care of bunions, HAV, there may be a need to change footwear, so it is able to fit properly and be compliment with orthotics. Surgical correction of bunions, HAV is available, however should only be considered when conservative care has failed to reduce the onset of bunions, HAV. It is only considered if there is a clear sign that it will induce a better quality of life for the patient.


Surgical Treatment
If non-surgical treatments fail to relieve bunion pain and when the pain of a bunion interferes with daily activities, it?s time to discuss surgical options with a foot and ankle surgeon. Together you can decide if surgery is best for you. A variety of surgical procedures is available to treat bunions. The procedures are designed to remove the ?bump? of bone, correct the changes in the bony structure of the foot, and correct soft tissue changes that may also have occurred. The goal of surgery is the reduction of pain. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

Prevention
To help prevent bunions, select your style and size of shoes wisely. Choose shoes with a wide toe area and a half-inch of space between the tip of your longest toe and the end of the shoe. Shoes also should conform to the shape of your feet without causing too much pressure.

Overview


Normally, when you walk or run, your heel is the first part of your foot to strike the ground. As your body weight shifts to the middle of the foot, the arch of the foot naturally flattens out a bit. This flattening is called pronation. If your feet flatten more than normal, it?s called over-pronation or flat feet. Over-pronation can cause many problems, such as an Achilles tendon injury or heel pain. It may lead to knee problems.


Causes


For those not familiar with the term pronation, you might be familiar with terms related to shoes and pronation such as ?motion control?, ?stability,? and ?neutral cushioned.? The terms motion control and stability are typically associated with the word ?over-pronation? or a foot that is supposedly pronating too much and needs correction. According to the running shoe industry, ?over-pronation? is a biomechanical affliction evident when the foot and or ankle rolls inward past the vertical line created by your leg when standing.


Symptoms


Symptoms can manifest in many different ways. Here is a list of some of the common conditions associated with over-pronation in children. Achilles Pain. Ankle pain. Arch Pain. Low back pain. Heel Pain. Knee Pain (Runner's knee and Chondromalecia of the patella) Osgood Schlatter Disease (pain below the knee) Shin Splints (pain in the front of the lower leg) Over-pronation does not necessarily mean your child has "flat feet." Even though children's arches may be relatively high when they lie down or sit, over-pronation may not be seen until your child is standing. A certain amount of pronation is normal. During normal walking or running ("gait cycle"), the heel strikes the ground and the foot rolls inward to absorb shock and adapt to the surface. This gait cycle is even more important if the running surface is uneven.


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.


Non Surgical Treatment


If you overpronate, you should talk with a foot and ankle specialist, especially if symptoms have not developed yet. Questions you may want to ask your doctor include what are the best running shoes on the market? Where can I find those shoes? If over-the-counter orthotics don?t work, how long should I wait before contacting you for custom-made orthotics? On my next visit, what type of diagnostic testing should I expect? If I limit the amount of time I spend running, will my overpronation symptoms disappear? What additional treatment options can we try?


Prevention


Strengthen the glutes to slow down the force of the foot moving too far inward. Most individuals who over-pronate have weak glute muscles and strengthening this area is a must. A simple exercise to strengthen glutes is lateral tube walking across a field/court/room. Place a lateral stretch band around your ankles and move your leg sideways while keeping your feet forward.