Hammertoe Correction Procedure

HammertoeOverview


What are hammertoes, mallet toes and claw toes? Often the words are used interchangeably to mean an abnormally contracted toe like the drawing above. Technically speaking, a "Hammer toes" is the name for a toe that is contracted at the first toe joint. If it's contracted at the second toe joint it is called a "mallet toe". IIf a toe is contracted at both toe joints, it is called a "claw toe". Each of these conditions can be quite uncomfortable and are cosmetically unappealing.


Causes


Footwear can contribute significantly to the development of hammertoes. Shoes that are too small force your toes into a curled position. Over time, your toe tendons adjust to this positioning, causing your toe or toes to hold a hammered shape. Athletes may be especially susceptible, because of the increased forces on the toes from shoes that are too small or tight. Heel elevation in footwear is also problematic, as it causes your toes to be pushed into the shoe?s toe box. Heel elevation additionally contributes to muscle imbalance. A common example of this is when your Achilles tendon-the tendon at the back of your leg that attaches your calf muscles to your heel bone-is too tight, causing the tendons on the top of your foot that attach to your toes to work too hard and hold your toes in an unnatural, elevated position.


HammertoeSymptoms


The most obvious symptom of hammer, claw or mallet toe is the abnormal toe position. This is usually combined with pain: the abnormal foot position leads to excessive friction on the toe as it rubs against any footwear which can be extremely painful. Corns & Calluses: repeated friction can result in the formation of a foot corn or callus on top of the toes. Stiffness, the joints become increasingly stiff. In the early stages, the toes can usually be straightened out passively using your hands, but if allowed to progress, the stiffness may be permanent.


Diagnosis


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. If the deformed toe is very painful, your doctor may recommend that you have a fluid sample withdrawn from the joint with a needle so the fluid can be checked for signs of infection or gout (arthritis from crystal deposits).


Non Surgical Treatment


What will a doctor do? Treat any foot complaints such as corns, calluses by periodically reducing the lesion and applying appropriate pads and dressings. Recommend the silicone toe prop. If an infection is present, then anti-septic dressings, antibiotics and pads to redistribute pressure away from the lesion may be necessary. In the case of a mallet toe, trigger toe or claw toe. If a corn occurs at the end of the toe, a silicone or leather prop may be used to straighten the toe. In a hammertoe deformity, a silicone prop to redistribute pressure away from a corn may be necessary. The doctor may give footwear advice. In severe cases, corrective surgery may be necessary. The doctor may recommend orthosis to correct a mechanical complaint of the foot, such as 3/4 length silicone insoles.


Surgical Treatment


Surgery to correct for a hammertoe may be performed as a day procedure. There are Hammer toes several different types of procedures that can be used depending on the foot structure and if the deformity is flexible or rigid.


HammertoePrevention


Certain exercises such as moving and stretching your toe gently with your hands and picking up small or soft objects such as marbles or towels can keep your toe joints flexible, simple exercises can stretch and strengthen your muscles. Limit high-heel use, well-designed flat shoes will be more comfortable than high heels. Don't wear shoes that are too short or too narrow, or too shallow, this is especially important for children going through periods of rapid growth, the toe area should be high enough so that it doesn't rub against the top of your toes.

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The Cause Of Bunions?


Overview
Bunions Hard Skin
Bunions are bony protrusions located at the base of the big toe that develop when the toe is slanted inward or overlaps the next toe. They can be very painful. Bunions form when the movement of the big toe influences the angle of the bones in the foot. The changes gradually develop into the characteristic bump, which over time becomes more and more noticeable.

Causes
The classic bunion, medically known as hallux abductovalgus or HAV, is a bump on the side of the great toe joint. This bump represents an actual deviation of the 1st metatarsal and often an overgrowth of bone on the metatarsal head. In addition, there is also deviation of the great toe toward the second toe. In severe cases, the great toe can either lie above or below the second toe. Shoes are often blamed for creating these problems. This, however, is inaccurate. It has been noted that primitive tribes where going barefoot is the norm will also develop bunions. Bunions develop from abnormal foot structure and mechanics (e.g. excessive pronation), which place an undue load on the 1st metatarsal. This leads to stretching of supporting soft tissue structures such as joint capsules and ligaments with the end result being gradual deviation of the 1st metatarsal. As the deformity increases, there is an abnormal pull of certain tendons, which leads to the drifting of the great toe toward the 2nd toe. At this stage, there is also adaptation of the joint itself that occurs.
SymptomsMany people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult-all contributing to chronic bunion pain.

Diagnosis
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
Detecting and treating bunions can relieve many of the symptoms associated with this condition. Doctors often consider whether the condition requires non-surgical or surgical treatment. The decision is based on the severity of the symptoms. Because bunions often get worse over time, early detection and proper treatment are very important. Some non-surgical methods to reduce the symptoms related to bunions include cushioning the area with padding or tape, taking medication to relieve pain and inflammation, using physiotherapy to reduce pain and related symptoms (e.g., ultrasound, whirlpool baths, joint mobilization), wearing custom orthotics to provide better movement and stability of the foot, wearing well-fitted comfortable shoes that are not too tight (if your shoes used to fit but now are too tight around the bunion area, you may be able to have them stretched in this area), using a special splint at night to decrease the amount the toe angles towards the other toes. When non-surgical methods do not provide relief, surgery may be needed. During surgery, the doctor will remove the tissue or bone in the area of the bunion and attempt to straighten the big toe, and may join the bones of the affected joint.
Bunions Hard Skin

Surgical Treatment
Bunion surgery is an option for those who have persisting pain and the condition is worsening. Surgery on a bunion can correct the bone deformity, increase function and relieve pain. Bunion surgery should not be considered lightly, the surgery is often successful but there is a rate of surgical failure. The big toe can move back into its previous place if the patient does not follow instructions, which will result in the pain returning. The surgical failure for bunions can be reduced greatly if activity restrictions are followed and proper footwear is worn after surgery.

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How Can I Tell If I Have Got Over-Pronation

Overview


Overpronation can affect people of all ages and it is particularly problematic for patients with high levels of activity. This problem is generally present at birth. Overpronation occurs with EVERY STEP taken. Considering the average person takes almost 8,000 steps per day and millions of steps in a lifetime, it's easy to see how the cumulative trauma from the unbalanced strain and excessive forces can lead to serious damage.Overpronation


Causes


In adults, the most common reason for the onset of Over-Pronation is a condition known as Post Tibial Tendonitis. This condition develops from repetitive stress on the main supporting tendon (Posterior Tibial Tendon) of the foot arch. As the body ages, ligaments and muscles can weaken. When this occurs the job of providing the majority of the support required by the foot arch is placed upon this tendon. Unfortunately, this tendon cannot bear the weight of this burden for too long. Eventually it fatigues under the added strain and in doing so the foot arch becomes progressively lower over a period of time.


Symptoms


Eventually, over-pronation can lead to a full list of maladies including flat feet, plantar fasciitis, plantar fibroma, neuromas, heel spurs, shin splints, ankle sprains, bunions, hammertoes, calluses, and pain in the arches, knee, hip and lower back. But it doesn?t have to go that far, because there are steps we can take to correct the over-pronation. In the vast majority of cases, we?ll prescribe custom foot orthotics, which will realign your ankles, redistribute the weight, support the arch and reduce the twisting. Many orthotics will fit snugly into your normal shoes. Although we?ll also take a look at the type of shoes you wear to see if they are contributing to the problem.


Diagnosis


At some point you may find the pain to much or become frustrated. So what are you options? Chances are your overpronation has led to some type of injury if there's pain. Your best bet is to consult with someone who knows feet. Start with your pediatrist, chiropodist or chiropractor. They'll be able to diagnose and treat the injury and give you more specific direction to better support your feet. One common intervention is a custom foot orthotic. Giving greater structural support than a typical shoe these shoe inserts can dramatically reduce overpronation.Over-Pronation


Non Surgical Treatment


Supportive orthotics in the shoe is a method commonly implemented to treat many common running injuries associated with pronation. An advantage of orthotics is that they often allow the sufferer to continue to participate in athletic activity and avoid other treatment options that could be potentially costly and time consuming. Seventy-five percent of injured runners are successfully treated with the prescription of orthoses. Orthotics are the most effective treatment for symptoms that develop from unusual biomechanics within the body such as overpronation, resulting in either great improvement or complete healing of the injury in about half the cases.


Surgical Treatment


Subtalar Arthroereisis. The ankle and hindfoot bones/midfoot bones around the joint are fused, locking the bones in place and preventing all joint motion. This may also be done in combination with fusion at other joints. This is a very aggressive option usually reserved for extreme cases where no joint flexibility is present and/or the patient has severe arthritic changes in the joint.

tag : Over-Pronation

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