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You know that people sometimes curl up in the fetal position in response to real or perceived threat. Your toes can do the same, but what threatens them is usually too-tight shoes. Toe deformities like hammertoes and claw toes often form in response to pressure from footwear that doesn’t fit properly. It is a common occurrence and can lead to foot pain and keep you from your favorite activities. Here’s the scoop on what’s happening in your feet.
Your toes move with opposing sets of muscles. The ones underneath help them curl or grab surfaces for better traction and balance. The ones on top pull the toe back into its normal straight line. When your toes are held in a cramped, curled-up position for long periods of time (like a day at the office in narrow-toed heels), the muscles can start to change. Those underneath shorten and get tighter from being cramped, and those on top of your toes stretch out and get weaker, so that they can’t hold your toe straight anymore.
These muscle imbalances affect the tendons further up your foot and leg. The extensor tendons along the top of the foot help you lift the front of it up as you walk. When toe muscles don’t work properly, this tendon will step in as a sub to help you extend or lift your toes. That can cause it to become tight, and pull the toe even farther out of position.
The flexor tendons along the bottom of your foot can come into play with a condition such as flat feet. They step in to help keep your foot stable when other structures aren’t adequate, and the constant pull against the underside of the toes where they attach can also contribute to hammertoe problems.
As long as the toe stays flexible, it may not cause a lot of problems, but it is a different story if it becomes rigid and stiff. Then, with hammertoes, the joint in the middle of your small toe stays in a bent-up position, so your toe looks like an upside-down letter V. In a mallet toe, it is the joint closest to your nail that bends, while the rest of the toe stays straight. When you have claw toes, both joints in your toe curl under, giving it that curved, claw shape.
The joint that bends will be higher than the rest of your toes, so it will start to rub against the top of your shoes. This may cause a painful corn to form on your skin. When the end of the toe bends down, it presses on the insole of your shoe, causing a callus to form at the tip. You may experience cramps in the muscles of your toes, as well, and sometimes not being able to straighten them affects your stability and balance.
If you have painful hammertoes, our first treatment is aimed at relieving the discomfort. Many times this can be done simply with softer and roomier shoes. There are also devices called hammertoe pads that help hold the toe in place or keep it from moving in order to reduce friction from your shoes.
If the toes are badly deformed or other treatments don’t stop the pain, you may need to consider surgery to correct the problem. There are various procedures, such as removing part of the bone or releasing or transferring tendons, which may be done in our office or as an outpatient. Plan on a few weeks of recovery time before you would be able to resume your normal activities.
Are you ready to move your curled toes out of their fetal position? Give Kevin Powers, DPM a call at 812-333-4422 and set up an appointment at our Bloomington, IN, office. We have an area-wide reputation for excellence in foot surgery and finding the answer to foot pain. Let us put that expertise to work for you. You can also schedule your visit using our webpage, and keep in touch with us via Twitter, Facebook, and Pinterest, as well as Google+.