“Are my toes normal”
“Why are my toes curled”
These are two common questions to a series of common toe deformities; hammer toes, claw toes and mallet toes. These deformities can happen at any or all of the toes, excluding the big toe and can exist with or without pain; depending on the severity, function and other structures involved. All of these classifications symbolize what the toe looks like, and what joint the deformity occurs at.
– Normal alignment at all joints of the toe
– Mal-alignment at two of the toe joints
– Mal-alignment at one of the toe joints
– Mal-alignment at all of the three toe joints
What causes these deformities?
There are many factors which can cause toe deformities. For example:
Muscle imbalances of the legs and feet. Sometimes our muscles in our legs and feet don’t work as equally as each other, which can result in one group of muscles out-powering another group of muscles. Usually in toe deformities, the flexor muscles in our feet over-power the extensor muscles.
Foot posture. Several different foot postures and a person’s biomechanics can be the primary cause of toe deformities. For example, Bunions can alter the forces of walking and general weight bearing to the smaller toes, increasing the load on them, which can lead to imbalances of muscle activity. This can ultimately lead to formation of hammer/claw/mallet toes.
Arthritis can disrupt the normality of a joint and therefore alter it’s function, leading to toe deformities (AND PAIN!)
Trauma. A badly stubbed toe, or dropping a heavy object on your foot are two examples of many which can alter the foot’s function structurally and functionally. The formation of a toe deformity after an accident may result as part of early healing (2-3 months) or it may be delayed, and take years for signs/symptoms to appear.
Poor fitted shoewear can have an impact if they hasn’t been correctly modified by a professional. Tight work shoes, high-heels and ballet flats are classic examples of shoes that apply pressure on our forefoot and toes, and if they are continuously worn, can alter our foot mechanics and function. The end point is development of toe deformities and other foot problems.
Other problems associated with toe deformities include build-up of callus under the ball of the foot, and corn formation in between toes or on the effected toes. Callus and corns can be PAINFUL!
A Podiatrist’s management strategies of these toe deformities include:
– taping/splinting
– callus and corn debridement and dressing
– toe off-loading devices
-corrective insoles/orthotics with a metatarsal dome
-addressing other foot structures which may be the primary cause
-appropriate foot wear prescription; deep and accommodative
-leg and feet strengthening and stretching exercises
-referral to surgeon (when the deformity is extreme and painful. This is a last resort; when all other treatment options have been exhausted..)
