A hammertoe is a toe that's curled due to a bend in the middle joint of a toe. Mallet toe is similar, but affects the upper joint of a toe. Otherwise, any differences between Hammer toe and mallet toe are subtle. Both hammertoe and mallet toe are commonly caused by shoes that are too short or heels that are too high. Under these conditions, your toe may be forced against the front of your shoe, resulting in an unnatural bending of your toe and a hammer-like or claw-like appearance. Relieving the pain and pressure of hammertoe and mallet toe may involve changing your footwear and wearing shoe inserts. If you have a more severe case of hammertoe or mallet toe, you may need surgery to experience relief.
Essentially, hammertoes are caused by an abnormal interworking of the bones, muscles, ligaments and tendons that comprise your feet. When muscles fail to work in a balanced manner, the toe joints can bend to form the hammertoe shape. If they remain in this position for an extended period, the muscles and tendons supporting them tighten and remain in that position. A common Hammer toe factor in development of hammertoe is wearing shoes that squeeze the toes or high heels that jam the toes into the front of the shoe. Most likely due to these factors, hammertoe occurs much more frequently in women than in men.
If the toes remain in the hammertoe position for long periods, the tendons on the top of the foot will tighten over time because they are not stretched to their full length. Eventually, the tendons shorten enough that the toe stays bent, even when shoes are not being worn. The symptoms of hammertoe include a curling toe, pain or discomfort in the toes and ball of the foot or the front of the leg, especially when toes are stretched downward, thickening of the skin above or below the affected toe with the formation of corns or calluses, difficulty finding shoes that fit well. In its early stages, hammertoe is not obvious. Frequently, hammertoe does not cause any symptoms except for the claw-like toe shape.
Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe.
Non Surgical Treatment
Orthotics are shoe inserts that can help correct mechanical foot-motion problems to correct pressure on your toe or toes and reduce pain. Changing shoes. You should seek out shoes that conform to the shape of your feet as much as possible and provide plenty of room in the toe box, ensuring that your toes are not pinched or squeezed. You should make sure that, while standing, there is a half inch of space for your longest toe at the end of each shoe. Make sure the ball of your foot fits comfortably in the widest part of the shoe. Feet normally swell during the course of the day, so shop for shoes at the end of the day, when your feet are at their largest. Don't be vain about your shoe size, sizes vary by brand, so concentrate on making certain your shoes are comfortable. Remember that your two feet are very likely to be different sizes and fit your shoe size to the larger foot. Low-heel shoes. High heels shift all your body weight onto your toes, tremendously increasing the pressure on them and the joints associated with them. Instead, wear shoes with low (less than two inches) or flat heels that fit your foot comfortably.
Any surgery must be carefully considered and approached in a serious manner, as any procedure is serious for the patient. But in most cases the procedure is relatively straight forward. The surgery can be done using local anesthetic and does not require hospitalization. The patient goes home in a special post-operative shoe or a regular sandal, and in most cases can walk immediately. That's not to say that the patient is walking or functioning normally immediately after the procedure. The patient must take some time off work to rest the foot and allow it to heal.
As long as hammertoe causes no pain or any change in your walking or running gait, it isn?t harmful and doesn't require treatment. The key to prevention is to wear shoes that fit you properly and provide plenty of room for your toes.
A bunion is a foot deformity where your big toe slants outward horizontally, pushing the tip of the big toe up against your little toes, and creating a characteristic sharp angle along the inside of your foot, at what?s called the first metatarsophalangeal joint-where your big toe connects to your foot. The reason for the deformity is an abnormal growth of bone, so it is not a condition that will correct itself naturally. Though bunions, or hallux valgus, as they are known in the medical community, are well-known among the general population for causing pain and discomfort, they can have a big impact on your running as well. Women?s marathon world record holder Paula Radcliffe, for example, lost several months of running because of a bunion on her foot.
Women traditionally have a higher rate of bunions, which is to be expected, since it is they who have traditionally worn shoes with high heels, a narrow toe box, or whatever fashion dictates from year to year. However, men can suffer from bunions as well, as can anyone for whom the right (or wrong) conditions exist, poor foot mechanics, improper footwear, occupational hazards, health and genetic predisposition. Finally, bunions have long been a condition associated with the elderly, and although they often appear in conjunction with inflammatory joint diseases such as arthritis (which is often associated with age), they can strike at any point in life, including adolescence.
The major symptom of bunions is a hard bump on the outside edge of the foot or at the base of the big toe. Redness, pain and swelling surrounding or at the MTP joint can also occur.
Bunions are readily apparent - the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don?t go away, and will usually get worse over time. But not all cases are alike - some bunions progress more rapidly than others. Once your surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.
Non Surgical Treatment
Bunions may be treated conservatively with changes in shoe gear, different orthotics (accommodative padding and shielding), rest, ice and medications. These sorts of treatments address symptoms more than they correct the actual deformity. Surgery, by an orthopedic surgeon or a podiatric surgeon, may be necessary if discomfort is severe enough or when correction of the deformity is desired. Orthotics are splints or regulators while conservative measures include various footwear like gelled toe spacers, bunion toes separators, bunion regulators, bunion splints and bunion cushions. There are a variety of available orthotics (or orthoses) including over-the-counter or off-the-shelf commercial products and as necessary, custom-molded orthotics that are generally prescribed medical devices.
Arthrodesis involves fusing together two bones in your big toe joint (metatarsophalangeal joint). The procedure is usually only recommended for people with severe deformities of the big toe joint, which make it too difficult for doctors to completely fix the joint, or when there's advanced degeneration of the joint. After arthrodesis, the movement of your big toe will be severely limited and you won't be able to wear high heels. An excision arthroplasty involves removing the bunion and the toe joint. A false joint is created by scar tissue that forms as a result of the operation. The procedure involves pinning the joint in place with wires, which will be removed around three weeks after surgery is carried out. An excision arthroplasty can only be used in certain circumstances, and is usually reserved for severe, troublesome bunions in elderly people.
The exact number of people who develop Achilles tendon injury is not known, because many people with mild tendonitis or partial tear do not seek medical help. It is believed to be more common in men but with the recent participation of women in athletics, the incidence of Achilles tendon injury is also increasing in this population. Overall, injury to the Achilles tendon is by far most common in the athlete/active individual.
Often the individual will feel or hear a pop or a snap when the injury occurs. There is immediate swelling and severe pain in the back of the heel, below the calf where it ruptures. Pain is usually severe enough that it is difficult or impossible to walk or take a step. The individual will not be able to push off or go on their toes.
Symptoms of an Achilles tendon injury are as follows. Pain along the back of your foot and above your heel, especially when stretching your ankle or standing on your toes; with tendinitis, pain may be mild and worsen gradually. If you rupture the tendon, pain can be abrupt and severe. Tenderness. Swelling. Stiffness. Hearing a snapping or popping noise during the injury. Difficulty flexing your foot or pointing your toes (in complete tears of the tendon).
In order to diagnose Achilles tendon rupture a doctor or physiotherapist will give a full examination of the area and sometimes an X ray is performed in order to confirm the diagnosis. A doctor may also recommend an MRI or CT scan is used to rule out any further injury or complications.
Non Surgical Treatment
Once a diagnosis of Achilles tendon rupture has been confirmed, a referral to an orthopaedic specialist for treatment will be recommended. Treatment for an Achilles tendon rupture aims to facilitate the torn ends of the tendon healing back together again. Treatment may be non-surgical (conservative) or surgical. Factors such as the site and extent of the rupture, the time since the rupture occurred and the preferences of the specialist and patient will be considered when deciding which treatment will be undertaken. Some cases of rupture that have not responded well to non-surgical treatment may require surgery at a later stage. The doctor will immobilise the ankle in a cast or a special hinged splint (known as a ?moon boot?) with the foot in a toes-pointed position. The cast or splint will stay in place for 6 - 8 weeks. The cast will be checked and may be changed during this time.
Surgery offers important potential benefits. Besides decreasing the likelihood of re-rupturing the Achilles tendon, surgery often increases the patient?s push-off strength and improves muscle function and movement of the ankle. Various surgical techniques are available to repair the rupture. The surgeon will select the procedure best suited to the patient. Following surgery, the foot and ankle are initially immobilized in a cast or walking boot. The surgeon will determine when the patient can begin weightbearing. Complications such as incision-healing difficulties, re-rupture of the tendon, or nerve pain can arise after surgery. Whether an Achilles tendon rupture is treated surgically or non-surgically, physical therapy is an important component of the healing process. Physical therapy involves exercises that strengthen the muscles and improve the range of motion of the foot and ankle.