A hammertoe is a contracted second, third, fourth, or fifth toe. They usually start out as mild deformities and progressively get worse over time. The abnormal bending can put pressure on the toe when wearing shoes, causing corns or calluses to form. Corns often form on top of the toe where it rubs against the shoe, and calluses may form on the bottom of the toe or the ball of the foot where your weight is transferred to.
Sometimes, hammertoes can be caused by some kind of trauma – like a previously broken toe – or they may be inherited. Because of the progressive nature of hammertoes, they never get better without some sort of intervention. Conservative treatment options include avoiding shoes that crowd the toes, wearing a buttress pad under the contracted toe, and trimming and padding the corns and calluses. Surgery may be needed to relieve the pain if the toe has become rigid.
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Hallux rigidus is a disorder of the joint located at the base of the big toe – different than bunions and sesamoiditis. It causes pain and stiffness in the big toe, and with time it gets increasingly harder to bend the toe. Hallux rigidus is actually a form of degenerative arthritis where the cartilage within the joint slowly becomes worn out. Because hallux rigidus is a progressive condition, the toe’s motion decreases as time goes on. In its earlier stage, motion of the big toe is only somewhat limited – at this point it is called “hallux limitus”. As the problem advances, the toe’s range of motion gradually decreases until it potentially becomes stiff – called “hallux rigidus” or a “frozen joint”.
Common causes of hallux rigidus are faulty biomechanics and structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint. For example, those with fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing hallux rigidus. In some people, hallux rigidus runs in the family and is a result of inheriting a foot type that is prone to developing this condition. In other cases, it is associated with overuse – especially among people engaged in activities or jobs that increase the stress on the big toe, such as workers who often have to stoop or squat. Hallux rigidus can also result from an injury – even from stubbing your toe. Or it may be caused by certain inflammatory diseases, such as rheumatoid arthritis or gout. There are various conservative treatment options, and surgery is a last resort.
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Haglund’s Deformity is a bony enlargement on the back of the heel that often leads to painful bursitis, which is inflammation of the fluid-filled sac (bursa) between the tendon and bone. In Haglund’s deformity, the soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes. The deformity is most common in young women who wear pumps – it is often called the “pump bump” because the rigid backs of pump-style shoes can create pressure that aggravates the enlargement when walking.
To some extent, heredity can play a role in Haglund’s deformity. In a person with high arches, the heel bone is tilted backward into the Achilles tendon causing the uppermost portion of the back of the heel bone to rub against the tendon. Having a tight Achilles tendon can also be a contributing factor – pain can be caused by compression of the tender and inflamed bursa. Another possible contributor to Haglund’s deformity is a tendency to walk on the outside of the heel resulting in a grinding of the heel bone against the tendon.
Anti-inflammatories, icing, heel lifts, heel pads, and immobilization may be used to alleviate the pain – and surgery as a last resort. After evaluating the structure of your heel bone through x-rays and examination, Dr. Mendoza will develop the best treatment plan for you. Click here or call our office at 615-452-8899 to schedule your appointment today!
A ganglion cyst is a jellylike fluid filled sac that originates from a tendon sheath or joint capsule. They are among the most common benign soft-tissue masses, and arise from trauma – whether it is a single event or repetitive micro-trauma. Although they most often occur on the wrist, they also frequently develop on the foot – usually on the top, but elsewhere as well. Ganglion cysts vary in size, may get smaller and larger, and may even disappear completely only to return later.
Oftentimes, the only symptom experienced is a noticeable lump. There can be tingling and burning associated with the cyst if it is touching a nerve, or a dull ache or pain if it is pressing against a tendon or joint. Some experience difficulty wearing certain shoes due to irritation between the lump and the shoe.
To diagnose a ganglion cyst, Dr. Mendoza will perform a thorough examination of the foot. When pressed in a certain way, it should move freely underneath the skin. Sometimes the surgeon will shine a light through the cyst or remove a small amount of fluid from the cyst for evaluation.
There are various options for treating a ganglion cyst of the foot, including: making shoe modifications, aspirating and injecting, and surgical removal of the cyst.
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Do you have pain associated with the base of your big toe but don’t think it is a bunion deformity? Sesamoiditis may be your problem!
The sesamoids are two pea-shaped bones located in the ball of the foot, beneath the big toe joint. They act as a pulley for tendons by providing leverage when the big toe pushes off while walking, running and jumping. The sesamoids also act as a weight bearing surface for the long bone, called the first metatarsal, connected to the big toe. Although many people become affected with it due to increased activity levels, it is most common in runners and dancers because they push off the ball of their foot so much.
Frequently wearing high-heeled shoes can also be a contributing factor to Sesamoiditis – which is an overuse injury with chronic inflammation of the sesamoid bones and tendons surrounding those bones. It is possible to fracture a sesamoid bone – either acutely with a direct blow or chronically with a hairline fracture from repetitive stress. After examining the foot and radiographic evaluation, Dr. Mendoza will help you decide the best course of action. Sometimes oral medications such as ibuprofen will be enough to cut the pain. Other options include steroid injections to reduce the inflammation, or even a surgical procedure to remove part or all of the affected sesamoid bone.
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