Angelic Kammes

Hammer ToeOverview


Hammer, claw, and mallet toes are toes that do not have the right shape. They may look odd or may hurt, or both. Tight shoes are the most common cause of these toe problems. A hammertoe is a toe that bends down toward the floor at the middle toe joint. It usually happens in the second toe. This causes the middle toe joint to rise up. Hammer toes often occur with bunions. Claw toe often happens in the four smaller toes at the same time. The toes bend up at the joints where the toes and the foot meet. They bend down at both the middle joints hammertoes and at the joints nearest the tip of the toes. This causes the toes to curl down toward the floor. A mallet toe often happens to the second toe, but it may happen in the other toes as well. The toe bends down at the joint closest to the tip of the toe.


Causes


More often than not, wearing shoes that do not fit a person well for too long may actually cause hammer toes. Wearing shoes that are too narrow or too tight for the person for extended periods of time may eventually take a toll on the person's feet. The same is true for women who like wearing high-heeled shoes with narrow toe boxes.


HammertoeSymptoms


The symptoms of a hammer toe include the following. Pain at the top of the bent toe upon pressure from footwear. Formation of corns on the top of the joint. Redness and swelling at the joint contracture. Restricted or painful motion of the toe joint. Pain in the ball of the foot at the base of the affected toe.


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


There are many non-surgical treatments to help relieve symptoms of hammertoe. The first step for many people is wearing the right size and type of shoe. Low-heeled shoes with a boxy or roomy toe area are helpful. Cushioned insoles, customized orthopedic inserts, and pads can provided relief as well. Splints or straps may be used to help correct toe position. Your doctor may show you toe stretches and exercises to perform. Your doctor can safely remove corns and calluses. You should not try to remove them at home.


Surgical Treatment


If your hammer, claw, or mallet toe gets worse, or if nonsurgical treatment does not help your pain, you may think about surgery. The type of surgery you choose depends on how severe your condition is and whether the toe joint is fixed (has no movement) or flexible (has some movement). A fixed toe joint often requires surgery to be straightened. A flexible toe joint can sometimes be straightened without surgery. Surgery choices include Phalangeal head resection (arthroplasty), in which the surgeon removes part of the toe bone. Joint fusion (arthrodesis), in which the surgeon removes part of the joint, letting the toe bones grow together (fuse). Cutting supporting tissue or moving tendons in the toe joint. How well surgery works depends on what type of surgery you have, how experienced your surgeon is, and how badly your toes are affected.


HammertoePrevention


Walking barefoot increases the risk for injury and infection. Being on your feet throughout the day can cause them to swell, this is the best time to buy shoes to get a better fit. Do not buy shoes that feel tight. Do not buy shoes that ride up and down your heel as you walk. The ball of your foot should fit into the widest part of the shoe. Remember, the higher the heel the less safe the shoe will be. Avoid shoes with pointed or narrow toes. If the shoes hurt, do not wear them. If you start noticing the beginning signs of hammer toes, you may still be able to prevent the tendons from tightening by soaking your feet every day in warm water, wearing toe friendly shoes, and performing foot exercises such as stretching your toes and ankles. A simple exercise such as placing a small towel on the floor and then picking it up using only your toes can help to restore the flexibility of tendons.

Overview
Bunions
A bunion is an often painful enlargement of bone or tissue around the joint at the base of the big toe. If you have a bunion, you will notice a bump on your big toe joint. The big toe may turn in toward the second toe and the tissues surrounding the joint may be swollen and tender. Bunions can come from a variety of causes, including diabetes, rheumatoid arthritis, or foot mechanics that place too much load on the ball of your foot. If untreated, bunions can worsen, leading to other serious complications, and even potentially require surgery. Early treatment is best, so if you?re suffering from bunions it?s smart to see a podiatrist for proper treatment and care.

Causes
Bunions develop when the pressures of bearing and shifting your weight fall unevenly on the joints and tendons in your feet. This imbalance in pressure makes your big toe joint unstable, eventually molding the parts of the joint into a hard knob that juts out beyond the normal shape of your foot. Experts disagree on whether tight, high-heeled or too-narrow shoes cause bunions or whether footwear simply contributes to bunion development. Other causes include inherited foot type, foot injuries, deformities present at birth (congenital). Bunions may be associated with certain types of arthritis, particularly inflammatory types, such as rheumatoid arthritis. An occupation that puts extra stress on your feet or one that requires you to wear pointed shoes also can be a cause.
SymptomsPatients complain of a cosmetically deformed foot, along with some skin changes which occur due to constant irritation. Pain and redness of the joint may also occur. Footwear can be difficult to fit due to the deformity and pain is often exacerbated with physical activity. Some patients may experience pain and difficulty with simple walking.

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
Fortunately, many bunions never go on to cause problems other than the cosmetic appearance. The easiest option is to try different shoes or padding, however this is not the answer for everyone. The various straps and braces that are commercially available are not proven to be particularly effective.
Bunions Callous

Surgical Treatment
Some sufferers choose to have the bunion surgically removed. This should always be a last resort as all surgeries carry risks. There are several types of surgical procedures to remove bunions and before deciding, you should speak to your surgeon at length about the facts and risks associated with surgery, including the recovery time and success rate of the operation to be done. Please note that if you have a surgical procedure and then return to your high heels and narrow-toed shoes, the bunion is likely to reoccur.

Overview
Achilles Tendon
Your Achilles tendon is a large band of tissue in the back of your ankle. It connects your calf muscles to your heel bone. The tendon helps you point your foot downward, rise on your toes, and push off when you walk. You use it almost every time you move. But repeated stress can make the tendon more prone to injury. It may become inflamed and develop small tears (tendonitis). A complete tear through the tendon is known as an Achilles tendon rupture.

Causes
The cause of Achilles tendon ruptures besides obviously direct trauma, is multifactorial. In many instances the rupture occurs about 2-6 cm before its attachment to the calcaneous (heel bone). In this area there is a weaker blood supply making it more susceptible to injury and rupture. Rigid soled shoes can also be the causative factor in combination with the structure of your foot being susceptible to injury.

Symptoms
It is important to know that pain at the back of the heel is not always due to Achilles tendon rupture. It may be due to bursitis (fluid accumulation in the heel due to repeated irritation) and tendonitis (pain along the Achilles tendon due to constant friction and irritation). The above disorders tend to improve with use of pain medications and rest, whereas Achilles tendon rupture requires surgery and/or a cast.

Diagnosis
Your doctor diagnoses the rupture based on symptoms, history of the injury and physical examination. Your doctor will gently squeeze the calf muscles, if the Achilles tendon is intact, there will be flexion movement of the foot, if it is ruptured, there will be no movement observed.

Non Surgical Treatment
Your doctor may advise you to rest your leg and keep the tendon immobile in a plaster cast while it heals. Or you may need to have an operation to treat an Achilles tendon rupture. The treatment you have will depend on your individual circumstances, such as your age, general health and how active you are. It will also depend on whether you have partially or completely torn your tendon. If you have a partial tear, it might get better without any treatment. Ask your doctor for advice on the best treatment for you. If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.
Achilles Tendinitis

Surgical Treatment
Surgery could allow for a quicker healing time. The procedure generally involves making an incision in the back of your lower leg and stitching the torn tendon together. Depending on the condition of the tissue, the repair may be reinforced with other tendons. As with any surgery, the main complication is the risk for infection, however, this risk is reduced by using smaller incisions.

Prevention
Here are some suggestions to help to prevent this injury. Corticosteroid medication such as prednisolone, should be used carefully and the dose should be reduced if possible. But note that there are many conditions where corticosteroid medication is important or lifesaving. Quinolone antibiotics should be used carefully in people aged over 60 or who are taking steroids.