Hammer toes, claw toes and retracted toes are deformities that affect the little toes and not the big toe. The toes curl over or lift off the ground which creates pressure on the tops of the toes or increased pressure under the ball of the foot causing callus and corns to form. The lesser toe deformities are due to a variety of reasons including neurological deficiencies, muscle imbalances, arthritis or even injuries to particular tendons. The toes often require shoes with a deeper area in the toe box portion of the shoe. Tubes for the toes, little rubber props and even orthotics can help to reduce the stresses through the toes due to the deformity.
A neuroma is thickening of the tissue around a nerve causing nerve related pain in the ball of the foot and into the toes. More often than not it affects the 3rd and 4th toes but the neuroma can be within any of the spaces between the toes. In addition to pain, numbness in the toes may occur or tingling between the toes, shooting pain into the toes or a ‘click’ might be felt under the forefoot. Treatment for a neuroma is aimed primarily at modifying the cause so wearing a wider fitting shoe with a lower heel is ideal. Addressing poor biomechanics with the use of orthotics is also essential as excessive pronation or supination can lead to a neuroma formation. Surgery is also an option but best utilised when conservative management has been unsuccessful.
Under the big toe joint are 2 small bones that sit within a tendon. They are called sesamoids and, if pressure is increased under the area, can become irritated and create sesamoiditis. Football boots can be an instigator of sesamoiditis due to stud configuration causing direct pressure under the area, as does a particular foot type where the big toe joint sits lower than the other joints known as a plantar flexed 1st ray. When the sesamoids are inflamed, they require offloading. It there is a fracture this can be done with a post operative boot otherwise an orthotic with particular forefoot padding if often sufficient.
For any forefoot pathology, a consultation with a podiatrist at Gait Way Podiatry is essential to discuss the appropriate treatment options for you.