Foot & Ankle Deformities

Over time, many people develop conditions and deformities in their feet and toes due to overuse, repetitive motion, constant pounding from strenuous exercise, wearing tight shoes or high heels, or trauma. This can result in conditions that distort the foot from its natural structure, place too much pressure that moves the toes out of alignment and cause wear spots that may cause discomfort.

Some of these conditions include:

Bunions —This common problem affects more than half of the women in the United States. A bunion forms in the joint of the big toe and can be traced to a history of wearing tight high heels. The bunion causes the base of the big toe to enlarge and become inflamed. Many women have pain and difficulty wearing shoes. As the bunion enlarges, the more painful it becomes, and in some cases, arthritis develops.

While bunions can run in families, you can avoid them by wearing appropriately sized shoes with a wide base. Avoid shoes that have narrow, pointed toes and heels higher than 1 ¼ inches. Once a bunion develops, your orthopaedic surgeon will recommend that you wear shoes that reduce pressure over the bunion and even wear protective pads over your toe. If this does not work, and you cannot get any relief from the pain, your doctor can remove the bunion. This type of minimally invasive surgery moves the toe to its original position. Recovery can take several months.

Hammertoes — This deformity, normally in the second, third or fourth toes, develops from wearing improperly fitting shoes or a muscle problem. Muscles in the toes work in concert to bend and straighten toes, but if the toe is held in a bent position for an extended length of time, the muscles can tighten. High heels and pointed-toe shoes exacerbate the problem.

Your physician will try some comfort measures before recommending corrective surgery. Try wearing shoes that have a wide toe box and avoid shoes with pointed toes or high heels. Your orthpaedic surgeon can also teach you some exercises to help stretch and lengthen the muscles.

If conservative therapies fail and you are still having pain, your orthopaedic surgeon can perform outpatient surgery to straighten your toes. The procedure requires that you rest and ice your foot and recover for several weeks. You will be able to walk, but will have to limit distances.

Claw Toes — This condition can be caused by wearing tight, high heels, but it is more often a result of nerve damage from disease. Diabetes and alcoholism can weaken the muscles in the foot and your toes begin to claw, digging into your shoes. Patients with claw toes can have a variety of symptoms, including:

• Toes that are bent up from the joints at the base of the foot
• Toes that bend down in the middle joints, pointing into the sole of the shoe
• A combination of toes bending up and down
• Painful corns that develop due to rubbing of the toes

If you are diagnosed with claw toes, your orthopaedic surgeon can recommend the right shoes for your foot, teach you how to stretch your toes with your hands to prevent further deformity, prescribe exercises or physical therapy to help stretch your muscles, and design special pads to fit into your shoes to keep your toes more comfortable. In extreme cases where the toes are essentially locked in place, surgery may be required.