Dr. Edward Carnvale, DPM FACFAS
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Anatomy Of Your Toes
Your toes and feet take you places. You use them to stand, walk, run, and dance.
Foot anatomy is complicated, and more than half of the bones in the human body are in your feet. Feet have three main sections – the forefoot, midfoot, and hindfoot. Your toes are in the forefoot.
In the forefoot are five toes, or phalanges, and five longer bones, or metatarsals, that connect the toes to the midfoot.
Each phalange consists of three phalanx bones – the proximal, middle, and distal – with the exception of the big toe, which has only has proximal and distal bones.
The joint between the metatarsals and phalanges is called the Metatarsophalangeal Joint, or MTP joint. These MTP joints form the ball of the foot and help your toes flex and extend. The joint between the proximal and middle phalanx is known as the Proximal Interphalangeal Joint, or PIP joint. The PIP joint helps toes curl and grip.
All toes except the big toe are know as lesser toes. Lesser toes and their joints flex and contract by the action of muscles, tendons, and ligaments on the top and bottom of your feet.
When forces such as tight shoes or high heels bend your toes, conditions such as hammertoe and claw toe can occur over time. Your toes are forced to work harder in less space, and the resulting muscle and tendon imbalance causes muscles to shorten and toes to curl, and may worsen the condition.
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Hammertoe is a condition caused by the joints of the metatarsal and phalanges contracting and bending the toe into an arched position that resembles a hammer. A common cause of hammertoe is a tight toe box in shoes, typically found with high heels that may be too small. The size, angle, and structure of the shoes force the toes into a compromised position, causing poor circulation, restricted movement, plus aggravation to the bones and ligaments in the foot and toes. Trauma is also a cause of hammertoes, and heredity may play a factor.
Early stages of hammertoe are mild, and the compromised joints are still flexible. At this stage, non-surgical treatment and appropriate footwear can help. Without treatment, however, the condition will worsen and joints will become stiff and inflexible. At that point, surgery is the only option.
Earliest stages are unsightly and uncomfortable but may not yet resemble the curved appearance of later stages. The appearance of hammertoe and its distinct shape is an indicator.
Symptoms of hammertoe include:
- Wearing shoes causes pain and irritation on toes.
- Corns and calluses appear between two toes, the ball of the foot, or on an affected toe that rubs against the shoe.
- Long-term friction also can cause open sores on toes.
- Burning sensation and a red, and inflammed appearance.
- Curved appearance that progresses if left untreated.
- Stiff, inflexible joints.