Toe deformities are common problems among adults caused by a combination of genetic factors, age, and injury. The injuries that most often result in a toe deformity are usually related to poor shoe choices. Other causes of toe deformities are poor biomechanics, wear and tear, arthritis, and genetic misalignment of the bones in the foot.
The forefoot is made up of four small toes and one large toe. The small toes are called phalanges and the big toe is called the hallux. Each phalange has 3 bones and 3 joints, however the hallux, or big toe, only has two bones and two joints. The forefoot and toes sit in front of the midfoot and hindfoot, which are responsible for bearing weight and performing movement activities. When the bones aligned in the midfoot are positioned incorrectly, it affects the positioning of the toes and toe deformities may results. If a person’s biomechanics, or their way of walking, running, and moving about, is not correct according to the structure of the foot, toe deformities may develop.
Several conditions could affect the biomechanics, or way of moving, of an individual. A knee or hip injury could throw off a person’s biomechanics in such a way that the toes become injured or deformed. Arthritis developing in the ankle or other joints could also affect the way a person moves, negatively affecting the toes.
Although the toes are a small part of the body, they have a big responsibility for proper balance and movement. When the toes become deformed, they may become painful. They may also create other problems in movement, which can have an ever-increasing effect on the rest of the body.
Occasionally, changes in shoe choice and body mechanics can help relieve the causes of toe deformities and allow the toes to return to their natural position, over time. Often, however, toe deformities are not noticed until they are advanced to a difficult state. Once a toe has become rigid, locked into place by frozen muscles and ligaments, only surgery can fix the toe deformity.
Dr. Jeffery Kleis is a podiatrist in Costa Mesa with more than 25 years of experience treating foot, ankle, and toe disorders, including toe deformities. Centrally located in Orange County, Dr. Kleis provides podiatry care to all of Southern California.
Dr. Kleis will use a physical examination and various imaging tests to determine the cause of your toe deformity and offer a range of solutions, depending on individual circumstances. Treatment for toe deformities ranges from a change in shoewear to surgery.
Dr. Kleis is committed to providing the latest treatments available and ensures that he and his team stay on the cutting edge of treatment technology. Dr. Kleis is an award-winning podiatrist that utilizes acoustic wave technology and low-level lasers to treat foot disorders whenever appropriate. Dr. Kleis will present a treatment plan that best relieves the painful symptoms of toe deformities and addresses the underlying cause, as well.
To schedule an appointment with Dr. Kleis, call (714) 760-4944 or book an appointment online.
Big Toe Deformities
Bunions are one of the most common big toe deformities. Bunions are a bump that forms at the base of the big toe, caused by pressure or anatomical abnormalities that move the big toe, or hallux, inward and away from the first metatarsal bone. This leaves the MTP (metatarsophalangeal) joint exposed and vulnerable to irritation and injury. As the joint is irritated and damaged from shoe wear or activity, the tissues around the joint become inflamed, forming the large bump that is referred to as a bunion.
Another common deformity of the big toe is hammertoe. Hammertoes are caused by shoes that don’t allow enough room for the toes to lay in their normal position. Over time, the toe becomes fixed in a bent formation, resembling a hammer. Hammertoes may be painful, especially when shoes are worn.
Treatment for big toe deformities may range from a change in shoe wear to surgery. Only a podiatrist can make a full examination, including the underlying causes, and prescribe a course of treatment for big toe deformities.
For an evaluation of a big toe deformity, contact Dr. Kleis at (714) 760-4944 or book an appointment online.
Second Toe Deformities
Hammertoe and mallet toe are common deformities of the second toe. While these deformities can also be found on the third through the fifth toe, they are more common in the second. The second toe is normally straight and lays alongside the big toe. When the big toe is moved over, as in the case of bunions, sometimes the big toe forces the second toe out of alignment. Injuries can also cause the second toe to move out of alignment, either lifting the second toe out of line or pushing it over from where it would normally lie.
Second toe deformities may be caused by certain shoes, genetic foot formation, or trauma. An imbalance in the muscles, tendons, or ligaments of the foot can also lead to a deformity in the second toe.
Only a podiatrist can make a full examination, including the underlying causes, and prescribe a course of treatment for second toe deformities.
For an evaluation of a big toe deformity, contact Dr. Kleis at (714) 760-4944 or book an appointment online.
Little Toe Deformity
A tailor’s bunion, similar to a regular bunion, forms at the base of the fifth toe, sometimes referred to as the pinky toe or baby toe. Typically, bunions form at the base, underneath the great toe. However, tailor’s bunions form on the outside of the foot, at the base of the smallest toe.
Tailor’s bunions form because of pressure on the outside of the foot, at the base of the small toe. Tailor’s bunions got their name because they were common among tailors in ancient times, who would commonly sit cross-legged on the ground as they worked. With their feet pressed against the ground, the greatest pressure was sometimes born by the curve of the foot at the small toe. As the tailor’s toe would rub against the ground, the pressure on the joint at the base of the toe would cause the toe to move out of alignment and the misalignment would result in the formation of the bunion.
A bump on the side of a tailor’s foot was so common that the bump became known as a “Tailor’s Bunion.”
Hammer Toe Deformity
Hammertoe is a common condition in the United States with more than 200,000 cases of hammertoe being treated every year. Hammertoe is caused by shoe choice, most commonly by shoes that have high heels and narrow toe boxes. Because of this, women are much more likely to develop a hammertoe than are men.
Genetics also play a role in whether or not a person will develop hammertoes during their lifetime. If parents or grandparents suffered from hammertoes, a person is much more likely to develop them, as well. Patients with diabetes or Rheumatoid Arthritis are also at greater risk of developing the condition.
The primary cause of hammertoes, however, is shoe style. High-heels and shoes with narrow toes force the toes into unnatural shapes and make developing the condition much more likely. Understanding risk factors that make a person more likely to develop hammertoes can help you determine whether your shoe choice is worth the risk.
What Causes Toe Deformities
The most common cause of toe deformities involves an imbalance in the muscles and tendons in the toe. Common causes of the muscle imbalance in the foot include:
- Genetic variations in foot structure
- Previous injuries or foot trauma
- Arthritis of the foot
- Wearing tight-fitting shoes can aggravate muscle imbalance and lead to toe deformities
Preventing Toe Deformities
You can avoid toe deformities, along with many other feet and ankle problems, by choosing shoes that fit correctly and offer the proper support.
When buying shoes, look for:
- Plenty of Room– Don’t choose shoes that are too short or have a narrow toe box.
- Avoid High Heels– Low heeled shoes will help you avoid back problems along with avoiding hammertoes.
- Shop For Shoes At The End of The Day– Your feet tend to swell throughout the day. By shopping at the end of the day, you will ensure that your feet will have plenty of room.
- Check Your Shoe Size– Just because you wore a 6 ½ in high school doesn’t mean you still wear a 6 ½. Your feet continue to grow as you age and extra weight can force your foot to spread. Check your shoe size every so often to be sure you’re getting the correct size shoe.
- Proper Fitting Shoes – Don’t go for the smaller size just because it’s attractive. Choosing a shoe that is the correct size is vitally important in avoiding hammertoe.
Toe Deformity Treatment
Your podiatrist, Dr. Kleis, has several non-surgical therapies to choose from when forming a treatment plan for toe deformities. What course is to be taken will depend on the severity of the condition and the responsiveness of the patient’s toes.
Non-surgical Interventions Include:
- Padding for corns and calluses– To treat the coexisting conditions of corns and calluses on your feet and toes, your podiatrist may prescribe medicated or over the counter pads that can shield your corns and calluses from further irritation and aid in healing.
- Changes in Shoewear Choices– A change in shoe wear is almost always necessary. Shoe styles are the primary cause of hammertoes forming and the condition cannot be addressed without avoiding those shoes that make the condition worse. It’s important to choose shoes that are wide enough for your feet, the correct length so that toes have room to move at the end of the shoe, and with a wide enough toe box that the toes can remain in their natural position.
- Orthotic Inserts – Occasionally a custom orthotic insert may be required to ease the muscle/tendon balance in your foot. Specially made, orthotic shoes may offer some relief, as well.
- Injection Therapy – Corticosteroid injections are sometimes necessary to relieve the pain and swelling of hammertoes.
- Anti-inflammatory Medications– Non-steroidal anti-inflammatory medications, like ibuprofen or naproxen, may be prescribed for swelling and pain.
- Splinting the Toe– Splints for the affected toe may help to straiten the toe while you sleep.
- Exercise – Strengthening exercises and stretching can help to keep the toes more flexible, which reduces the painfulness of the condition.
Surgery For Toe Deformity
In cases where surgery is required, Dr. Kleis can usually do the procedure in the office, under light sedation. Surgery is only required when the toes are rigid and the pain is too much for the patient to be able to wear normal shoes. The surgery is almost always successful and the discomfort to the patient is minimal.