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Toe Injuries & Education

Toe Injuries & Education

The forefoot is described as the front part of the foot which includes the ball of the foot and the toes. It is comprised of metatarsal and phalanges bones. Metatarsal bones, which are the 5 long cylindrical bones and located just before the phalanges (toes) in the foot, are numbered 1-5 starting with the big toe (hallux) and working outward. The shape of the ball of the foot -- where the metatarsal bone head resides-- is convex in shape and is called the transverse arch of the foot. Joined to the metatarsal bones by a joint called the metatarso- phalangeal joint are the phalanges or toe bones. The phalanges/toes work with ligaments and tendons to provide movement, enhance balance, and propel our body forward in walking and running.

METATARSALGIA

METATARSALGIA
Definition:Metatarsalgia is a catch-all phrase that basically means 'a pain in the ball of the foot'.The ball of the foot is made up of 5 joints called the metatarsophalangeal joints. It is the joint at which the toes begin. Underneath these joints, there exists a natural fat pad for absorption of shock and protection to the joints. Also, an arch exists at this joint in an upward arc, called a metatarsal arch.
Function:These joints have movement in a hinge form, up and down to move the toes. Also, they allow for shock absorption and help propel us into our next step.
Mechanism of Injury

Pain in the ball of the foot can come on insidiously or gradually or can result due to trauma, such as falling or high impact sports.

Signs & Symptoms

• Pain in the ball of the foot can range from a dull ache to a sharp shooting pain, occassionally proceeding right into the toes
• A sensation of walking on a pebble may be experienced
• Swelling or redness may be apparent at the ball of the foot calluses may form under the ball of the foot where excessive forces exist

Causes

• Can be as a result of the metatarsal arch dropping
• Degeneration or thinning of the fat pad
• Ill fitting or narrow shoes (high heeled or pointy shoes)
• Flat or over-pronated feet
• Prominent metatarsal heads
• Arthritis
• Short first toe (Mortons toe) -overuse or prolonged walking or standing
• Trauma to the foot
• Weakening of the ligaments, muscles and plantar fascia

Pedorthic Treatments

Custom made Orthotics are one of the most effective methods to reduce your metararsal pain. They are able to redistribute and load the foot in a different way in order to decrease stress to the affected area. Pedorthists use interventions such as a metatarsal domes and bars to offload stress to lift and separate the metatarsal heads. Proper footwear is also pivotal to your recovery such as a structured shoe with a good forefoot rocker bottom and increased cushioning. Talk to your Pedorthist about proper footwear choices for you.

Other Treatment

• STRETCHING: calf stretch
• ICE: 10-15 minutes to relieve pain and reduce swelling
• OTHER TREATMENT may include pain and anti-inflammatory medication.

HAMMER/CLAW TOES

HAMMER/CLAW TOES
Definition:Normal toes extend straight out, but when hammer/claw toes develop they will have an abnormal bend at the middle joint of the toe. This generally occurs in the 2nd, 3rd and 4th toes with the 2nd toe being the most common.
Function:The main function of the toes is to enlarge the contact surface area of the forefoot for walking. In general toes assist in balance, gripping and propulsion.
Mechanism of Injury

When the extending and flexing muscles of each toe do not work together, there becomes an imbalance in the pressures at the joints of the toe. This in turn creates a tendancy of the toe to flex or claw.

Signs & Symptoms

• Your toes no longer extend straight out but rather look like upside down 'U's or 'V's
• Hard skin known as corns may develop on the top joints of your toes from rubbing on the inside of footwear that may now be too shallow.
• Pain can also develop under the ball of the foot of the bent toe.
• Toe joints may become an angry red colour.

Causes

• Bunions/Hallux Valgus in where the big toe drifts towards the 2nd and lesser toes, which crowds the lesser toes and changes the mechanics
• Improper fitting footwear is one of the biggest reasons for hammer/claw toes.

Pedorthic Treatments

Custom made Orthotics can be an effective method to reduce your toe discomfort. They are able to redistribute and load the foot in a different way in order to decrease stress to the toes. Pedorthists use interventions such as supporting your medial/inside arch, and using metatarsal domes and bars to support the metatarsal arch. Proper footwear is also pivotal to your recovery. Shoes with a wide and deep toebox along with no stitching across the toes will decrease pressure on the toes. Toe crests, toe spacers and silicone sleeves can help reduce the friction in some areas. Talk to your Pedorthist about proper footwear choices for you.

Other Treatment

• Physiotherapy
• Surgical correction
• Splinting devices may hold toes down in your shoes

BUNIONS/HALLUX VALGUS

BUNIONS/HALLUX VALGUS
Definition:Bunions/Hallux Valgus is the bony enlargement of the first toe joint. Bunions can be associated with a drifting of the big toe toward the other toes of the foot.
Function:Normal function of the big toe joint is to propel your body forward and to assist balance.
Mechanism of Injury

The big toe may become mechanically mal-aligned and fails to function efficiently. Degeneration around the first toe joint may enlarge the joint and cause pain.

Signs & Symptoms

• Bulging bump on the inside of the big toe joint
• Swelling and/or redness around the big toe joint
• Corns or calluses
• Persistant or intermittent pain at the big toe joint
• Restricted movement of the joint

Causes

• Short first toe
• Genetics and family history
• Narrow or pointy toed shoes
• Certain sports such as soccer or ballet
• An over pronated foot (arch and ankle rolling inward) will create excessive pressure at the big toe joint

Pedorthic Treatments

Custom made Orthotics can be an effective method to reduce your bunion pain. They are able to redistribute and load the foot in a different way in order to decrease stress to the affected area. Pedorthists use interventions such as supporting your medial/inside arch, using metatarsal domes and bars to support the metatarsal arch. Proper footwear is also pivotal to your recovery. Shoes with a wide and deep toebox along with no stitching at the bunion will decrease pressure to the first toe joint. Talk to your Pedorthist about proper footwear choices for you.

Other Treatment

• Toe spacers may be effective in decreasing friction on the next toe
• In extreme circumstances surgery may be indicated.

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