![]() ![]() ![]() Strengthening exercises might be as simple as pulling a towel on the floor with your toes, pushing your toes into the floor to correct their position, or trying to actively lift your toes up into straighter alignment. ![]() An imbalance of these muscles occurs when the claw or hammer deformity has been present for a period of time. The goal with strengthening exercises is to improve the muscle balance between the deep (intrinsic) toe muscles and the surface (extrinsic) muscles of the toe. Strengthening exercises will also be prescribed. Your therapist will also show you how to mobilize your own toes, and will prescribe some toe, foot, and calf stretches to encourage your toes to return back into their normal position. If your toes are still flexible and can be straightened out from their claw or hammer toe position then your therapist may mobilize your toe joints to provide a stretch to the tightened tissues and to encourage the joints to move through their normal motions. Your therapist can also discuss trimming the calluses to relieve some of the pressure on them. In these cases your therapist can advise you on how to use pads to protect the callused areas. In some cases pressure points or calluses will have developed over the tops of the toes where they have been pushing against the ill-fitting shoe. Wearing proper shoes is the single most important action required to avoid the advancement of hammer or claw toes while they are still flexible. For women it is advisable to avoid wearing high heels as much as possible as this adds to the pressure on the toes. You may also need to look for shoes that have more depth in the toe box such that the top of your shoe does not press into the top of your toe. You should wear shoes that are the proper size for you (long enough to allow the longer toes to have room), have wide toe boxes, and that have soft insoles in order to avoid pressure on the toes. Regardless of how far advanced the deformity is or how rigid your toes are, your therapist will advise you on proper footwear. Your Physical Therapist will examine your foot and determine how flexible your toes are, and how far advanced your toe deformity is. Treatment for hammer or claw toes at Galena Sport Physical Therapy can be quite helpful if the deformity of the foot is not too advanced and the tissues of the foot remain flexible. What can be done for the problem? Non-surgical Rehabilitation This type of muscle imbalance can also occur from more serious nerve problems. Claw toes can come from a muscle imbalance in which the deeper (intrinsic) toe muscles are weaker than the surface (extrinsic) muscles of the toes. The big toe angles too far toward the middle of the foot, and the second toe can end up with a hammer toe deformity.Ĭlaw toes are common in people with high arches. If you combine pointed shoes with high heels then the foot is constantly being pushed downhill into a wall with the toes squished like an accordion.Ī hammer toe in the second toe is also common in people who have a bunion in the big toe. Shoes that are pointed make matters even worse. ![]() In many people, the second toe is actually longer than the big toe, and if shoes are sized to fit the big toe, the second and maybe even the third toe will have to bend to fit into the shoe. Related Document: Galena Sport Physical Therapy's Guide to Foot Anatomyīoth of these problems are often, but not exclusively, the result of wearing a shoe that is too short. A claw toe deformity has a cocked up MTP joint, and both the middle joint (PIP) and the small joint at the end of the toe (the DIP) are curled downward like a claw. In a hammer toe deformity, the first joint (MTP) is cocked upward, and the middle joint (PIP) is bent downward. Two tendons run along the bottom of each toe that allow us to curl our toes, and one tendon runs along the top that raises the toe. A joint capsule made of ligaments and connective tissue holds the bones together and surrounds each joint. The second joint is the proximal interphalangeal joint (or PIP joint), and the last is the distal interphalangeal joint (or DIP joint). The ball of the foot is formed by the MTP joints. The metatarsophalangeal joint (or MTP joint) is the first joint that connects the toe to the foot. The toe bones connect to form the toe joints. Proximal means closer, distal means further away. Next comes the middle phalanx, and last is the distal phalanx. Moving down the foot from the metatarsal bone are three smaller bones, called phalanges (the big toe only has two.) The first of these small bones is called the proximal phalanx. Each of the four smaller toes starts with a metatarsal bone within the forefoot. The forefoot and toes are made up of several bones. ![]()
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