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Contracted Toe Tendon Pain

June 27, 2015
HammertoeOverview

A Hammer toes is a toe that is bent because of a weakened muscle. The weakened muscle makes the tendons (tissues that connect muscles to bone) shorter, causing the toes to curl under the feet. Hammertoes can run in families. They can also be caused by shoes that are too short. Hammertoes can cause problems with walking and can lead to other foot problems, such as blisters, calluses, and sores. Splinting and corrective footwear can help in treating hammertoes. In severe cases, surgery to straighten the toe may be necessary.

Causes

Hammer toes are most frequently caused by a muscle - tendon imbalance in the foot, and are seen both in adults and children. Foot muscles work in pairs to straighten and bend the toes. If your foot has a biomechanical defect, the muscles tighten and the tendons shorten. Eventually, the toe muscles can?t straighten the toe, even when barefoot. Contributing factors are poor choices in footwear, arthritis, or trauma.

Hammer ToeSymptoms

Common reasons patients seek treatment for toe problems are toe pain on the knuckle. Thick toe calluses. Interference with walking/activities. Difficulty fitting shoes. Worsening toe deformity. Pain at the ball of the foot. Unsightly appearance. Toe deformities (contractures) come in varying degrees of severity, from slight to severe. The can be present in conjunction with a bunion, and develop onto a severe disfiguring foot deformity. Advanced cases, the toe can dislocate on top of the foot. Depending on your overall health, symptoms and severity of the hammer toe, the condition may be treated conservatively and/or with surgery.

Diagnosis

Some questions your doctor may ask of you include, when did you first begin having foot problems? How much pain are your feet or toes causing you? Where is the pain located? What, if anything, seems to improve your symptoms? What, if anything, appears to worsen your symptoms? What kind of shoes do you normally wear? Your doctor can diagnose hammertoe or mallet toe by examining your foot. Your doctor may also order X-rays to further evaluate the bones and joints of your feet and toes.

Non Surgical Treatment

The most common treatment is to wear more comfortable shoes. When choosing a shoe, make sure the toe area is high and broad and has enough room for hammer toes. If there is chronic pain, surgery may be needed to correct a malalignment. Surgical treatments are aimed at loosening up the contracted toe joints to allow them to align properly. Other types of treatment are products designed to relieve hammer toes, such as hammer toe crests and hammer toe splints. These devices will help hold down the hammer toe and provide relief to the forefoot. Gel toe shields and gel toe caps can also be used. Gel toe shields and toe caps will help eliminate friction between the shoe and the toe, while providing comfort and lubrication.

Surgical Treatment

There are several surgical methods to correct a hammer toe. Your physician will decide which method will be most beneficial to you depending Hammer toe on the severity of your deformity, the direction the toe is deviating and the length of the affected toe. Some common surgical methods include. Arthroplasty. To promote straightening, half of the joint located directly underneath the crooked part of the toe is removed. Arthrodesis (fusion) To promote straightening, the joint directly underneath where the toe is crooked is completely removed. A wire or pin is inserted to aid healing. Tendon transfer. Performed alone or in combination with other procedures, a surgeon will take tendons from under the toe and ?re-route? them to the top of the toe to promote straightening. Basal phalangectomy. Performed to assist patients with severe stiffness, this procedure removes the base of the bone underneath the toe. Weil osteotomy. Performed to assist patients with severe stiffness, this procedure involves shortening the metatarsal bone and inserting surgical hardware to aid healing.

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