Hammer Toe Pain After Surgery

HammertoeOverview


Hammer toes is a painful deformity wherein a toe bends unnaturally and becomes clawlike. This happens because the tendons of the toe contract abnormally, forcing the toe to bend downward and the middle joint of the toe to protrude upward. Although any toe may be affected, hammertoe usually affects the second toe. The toe assumes a clawlike position and cannot be straightened out. When someone with hammertoe wears shoes, the toe is constantly rubbed, so walking may become especially painful if a callus on the sole of the foot or a corn on the top of a toe develops.


Causes


Ill-fitting shoes or a muscle imbalance are the most common causes of Hammer Toe. If there is an issue with a muscle in the second, third or fourth toes preventing them from straightening, Hammer Toe can result. If one of these toes is bent long enough in one position, the muscles tighten and cannot stretch out. Left untreated, surgery may be required. Women are especially prone to developing Hammer Toe because of their shoes. Hammer Toe results from shoes that don?t fit properly. Shoes that narrow toward the toe, pushing smaller toes into a bend position for extended periods of time. High heels that force the foot down into a narrow space, forcing the toes against the shoe, increasing the bend in the toe.


HammertoeSymptoms


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.


Diagnosis


Your doctor is very likely to be able to diagnose your hammertoe simply by examining your foot. Even before that, he or she will probably ask about your family and personal medical history and evaluate your gait as you walk and the types of shoes you wear. You'll be asked about your symptoms, when they started and when they occur. You may also be asked to flex your toe so that your doctor can get an idea of your range of motion. He or she may order x-rays in order to better define your deformity.


Non Surgical Treatment


For hammertoes that are still flexible, a podiatrist might recommend padding or taping the toes to relieve pain and orthotic inserts for shoes to minimize pressure and keep the toe properly aligned. Anti-inflammatory drugs or corticosteroid injections can relieve pain and inflammation. For more advanced cases of hammertoe, a podiatrist might recommend a surgical procedure to cut the tendon, allowing the toe to straighten. For hammertoes that have become rigid, a more complicated surgery might be needed, during which the podiatrist removes part of the bone at the deformed joint to allow it to straighten.


Surgical Treatment


Surgical correction is necessary in more severe cases and may consist of removing a bone spur (exostectomy) removing the enlarged bone and straightening the toe (arthroplasty), sometimes with internal fixation using a pin to realign the toe; shortening a long metatarsal bone (osteotomy) fusing the toe joint and then straightening the toe (arthrodesis) or simple tendon lengthening and capsule release in milder, flexible hammertoes (tenotomy and capsulotomy). The procedure chosen depends in part on how flexible the hammertoe is.


Hammer ToePrevention


Wear thick-soled shoes if you walk on hard surfaces hammertoe on a regular basis. Wear shoes with low heels. Have your feet checked regularly by a podiatrist to ensure that no deformities or conditions are developing. Do stretching exercises daily to strengthen the muscles in your feet.

Overpronation Of The Foot

Overview


Overpronation is the most common abnormality found in the foot, and for this reason, is the most studied. The term that most people attribute to overpronation is ?flat feet.? Pronation is the rolling in of the foot and the collapse of the arch. Every person pronates to some extent and this is a necessary moment in the normal walking cycle as it allows the forefoot to make complete contact with the ground. A foot that overpronates acts like a loose bag of bones during the walking cycle. This makes this type of foot very flexible but inefficient. The foot has to work much harder to propel the body, fatiguing easily and placing mechanical stresses on the lower body. We like to use the analogy of digging a hole in the dirt. Overpronating feet are like using a broom to dig the hole. It won?t break down quickly, but you will be digging for a very long time, or until eventually wear and tear will take effect. Wouldn?t you rather have a shovel to work with. This is in essence what an orthotic can do for your feet. This is why orthotics have become an evidence based treatment for so many foot ailments, as they can effectively manage overpronation.Overpronation is when a person pronates too much and for too long. This places excess stress on the tendons and ligaments in the foot and ankle.Overpronation


Causes


Over-pronation is very prominent in people who have flexible, flat feet. The framework of the foot begins to collapse, causing the foot to flatten and adding stress to other parts of the foot. As a result, over-pronation, often leads to Plantar Fasciitis, Heel Spurs, Metatarsalgia, Post-tib Tendonitis and/or Bunions. There are many causes of flat feet. Obesity, pregnancy or repetitive pounding on a hard surface can weaken the arch leading to over-pronation. Often people with flat feet do not experience discomfort immediately, and some never suffer from any discomfort at all. However, when symptoms develop and become painful, walking becomes awkward and causes increased strain on the feet and calves.


Symptoms


Not all foot injuries affecting runners are necessarily down to a particular running gait; it is rarely that simple to diagnose how a foot problem developed . Simply being an overpronator does not mean that a foot injury has been caused by the running gait and it could be due to a number of factors. However mild to severe overpronators tend to be at a higher risk of developing musculoskeletal problems due to the increased stresses and strains which are placed on the body when the foot does not move in an optimum manner. The following injuries are frequently due to overpronation of the feet. Tarsal tunnel syndrome. Shin splints. Anterior compartment syndrome. Plantar fasciitis. Achilles tendonitis. Bunions. Sesamoiditis. Stress fractures. Back and hip pain. Ankle pain.


Diagnosis


Look at the wear on your shoes and especially running trainers; if you overpronate it's likely the inside of your shoe will be worn down (or seem crushed if they're soft shoes) from the extra strain.Over-Pronation


Non Surgical Treatment


Orthotics are medical devices used to provide support to correct a physical abnormality. They can provide arch support when needed to remedy over-pronation, and in this particular cases the orthoses used are usually convenient shoe inserts. These can be taken in and out of shoes, and will be carefully tailored by your podiatrist to the specifics of your foot. It can take some weeks before the effects of the inserts can become truly noticeable, and in many cases your podiatrist will want to review your orthotics within a few weeks to make fine adjustments based on how well they have worked to reduce your pain.


Surgical Treatment


Calcaneal "Slide" (Sliding Calcaneal Osteotomy) A wedge is cut into the heel bone (calcaneus) and a fixation device (screws, plate) is used to hold the bone in its new position. This is an aggressive option with a prolonged period of non-weightbearing, long recovery times and many potential complications. However, it can and has provided for successful patient outcomes.

How To Take Care Of Bunions


Overview
Bunions
A bunion is an enlargement of ?the metatarsophalangeal (MTP) joint?, this is the big toe?s base joint that forms when the bone or tissue moves out of place. This forces the toe to bend toward the others, causing an often painful lump of bone on the foot. The MTP joint, which carries lots of weight, is stiff and sore, making even the wearing of shoes difficult or impossible. It also causes swelling of the feet to occur. Hammer toes are also associated with the formation of bunions.

Causes
Bunions are sometimes genetic and consist of certain tendons, ligaments, and supportive structures of the first metatarsal that are positioned differently. This bio-mechanical anomaly may be caused by a variety of conditions intrinsic to the structure of the foot, such as flat feet, excessive flexibility of ligaments, abnormal bone structure, and certain neurological conditions. These factors are often considered genetic. Although some experts are convinced that poor-fitting footwear is the main cause of bunion formation, other sources concede that footwear only exacerbates the problem caused by the original genetic structure. Bunions are commonly associated with a deviated position of the big toe toward the second toe, and the deviation in the angle between the first and second metatarsal bones of the foot. The small sesamoid bones found beneath the first metatarsal (which help the flexor tendon bend the big toe downwards) may also become deviated over time as the first metatarsal bone drifts away from its normal position. Arthritis of the big toe joint, diminished and/or altered range of motion, and discomfort with pressure applied to the bump or with motion of the joint, may all accompany bunion development. Atop of the first metatarsal head either medially or dorso-medially, there can also arise a bursa that when inflamed (bursitis), can be the most painful aspect of the process.
SymptomsA bony bump along the edge of the foot, at the base of the big toe (adjacent to the ball of the foot) Redness and some swelling at or near the big toe joint. Deep dull pain in the big toe joint. Dull achy pain in the big toe joint after walking or a sharp pain while walking. The big toe is overlapping the second toe, resulting in redness, calluses, or other irritations such as corns.

Diagnosis
A doctor can very often diagnose a bunion by looking at it. A foot x-ray can show an abnormal angle between the big toe and the foot. In some cases, arthritis may also be seen.

Non Surgical Treatment
Apply a commercial bunion pad around the bony prominence, use only non-medicated pads. Wear shoes with a wide and deep toe box. You should be able to "dimple" the leather over your bunion. Avoid all high heeled shoes. If your bunion becomes painful red, and swollen try elevating your foot and applying ice for about 20 minuets every hour. If symptoms persist, consult your podiatrist or physician.
Bunions

Surgical Treatment
The aim of surgery is to correct the cause of the bunion and prevent it growing back. Which type of surgery your podiatric surgeon recommends will depend on the severity of your bunion. Because there are risks and complications with any type of surgery, it?s not usually advised unless your bunions are causing pain, or if it is starting to deform your other toes.

Prevention
Shop for shoes that possess a removable liner, or insole, and stand on the liner after you have removed it from your shoe. This is an effective method to see if your shoe is wide enough in the forefoot to accommodate your bunion. If your bunion and forefoot are wider than the insole, your shoe will squeeze and constrict your bunion and create the symptoms that define this health problem. The insole should also be wide enough to fully accommodate your big toe when it points outward, away from your other toes.
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Crystle Altwies

Author:Crystle Altwies
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