Hammertoe Video

The second toe is a hammertoe sitting above the now underlying first and third toes.

This video does not get much attention but it is packed with a lot of good information. Rich

https://youtu.be/plTrtNsmPPY

Help for bunions and hammertoes: Correct Toes

I have been looking for a product like Yoga Toes, that will be help to hammertoe and bunion patients, and that can be worn to walk in some shoes. One of my patients is wearing Correct Toes while walking in Keen (extra wide) athletic shoes. I hope it helps some of you. Rich

Hammertoe Advice

Email sent to drblakeshealingsole.com on 1/20/11

Question, currently I suffer from hammertoes on one foot, it is the second toe next to Big toe. It is completely dislocated, now on my right foot for the last year I'm having a lot of pain and my foot is swollen and the second toe is starting to turn under some. My biggest issue right is I have this sore foot and shin splints, I can't walk very far anymore because of it, I can't shop for long or do any standing in one place very long. Do you have any suggestions?

Gloria

Dear Gloria, I am imaging that you have a hammertoe that looks like my patient Paula below.

Here her toe is dislocated with the big toe now moving under the second toe. As the 2nd toe goes up, the 2nd metatarsal is pushed down against the ground much more than normal allowing for stress to build up in the tissues. The soft tissues under the second metatarsal/toe joint begin to scream bloody murder and pain starts. This pain causes swelling which causes more pain, and a vicious cycle is created.

The top five self treatments that you can easily start are:1.Budin Splint (either single or double loop)

http://www.drblakeshealingsole.com/2010/04/pain-in-front-of-foot-possible-help.html

2. Start wearing YogaToes or a knockoff

http://www.drblakeshealingsole.com/2010/07/help-for-bunions-and-hammertoes.html

3.  Ice massage three times daily

http://www.drblakeshealingsole.com/2010/04/ice-or-cold-therapy-helps-in-injury.html

4. Avoiding bending the toe joints as much as humanly possible (ie. stay flat footed on the ellyptical machine).

http://www.drblakeshealingsole.com/2010/07/arch-support-with-otc-hapads-help-for.html

5. Begin using Hapad Small Longitudinal Medial Arch self adhesive pads in most shoes.

When you are in alot of pain, I would probably try to rest the foot in a removable boot and try to get an MRI to find out what is going on. If finances are an issue, the removable boots can be purchased online and try to wear for 6 to 8 weeks while you ice three times daily.

I sure this helps you.

Hammertoes: Help with Toe Crests

     What is being demonstrated is a small toe crest for pain at the tip of a crooked hammertoe. They come in left and right with the thickest part under the toe closest to the big toe. Here Albert's pain is on the end of his fourth toe. The elastic band should be relatively loose around the 4th toe filling in the under surface of the toe area called the "sulcus". To keep the elastic band on loosely, a piece of scotch or paper tape attaching the band to the skin on the top of the foot can hold the elastic band in place. It should never feel like it is cutting off the circulation, or that the toe is throbbing. You can tell by the photos that it was perhaps too tight on Albert by the indentation it left on his skin.

Here you can see the toe crest attached to the base of Albert's toe. His sore is at the tip of the 4th toe so the material lifts the tip off the ground slightly relieving the pressure. Due to Albert's foot size, I could also have used a medium and placed the band over the 3rd toe. You just try to get some bulk of the material under the effected toe. Toe crests are "necessary evils" (one of my favorite sayings especially about casts) since they do not straighten hammertoes, but probably if worn for awhile, make the hammertoe curl more. Another product I use is a foam toe cap designed initially for ballet dancers. It is more bulky than a toe crest, but does protect the toe, and produce a straightening effect on the toe. It is always a trade off with these various inserts. I have not found patients to like the gel version of these toe crests. Toe crests can be modified simply if they irritate you in a spot by cutting out an area and putting a small piece of tape over the area. Believe me, they do not bleed when you cut into them.

I am a San Francisco Podiatrist and love my San Francisco Giants. If any fans are reading this and have not seen the incredible video by Ashkon, I know you will enjoy. Thank you Ashkon. I am a fan!!

Bunions: Socks by Injinji

Injinji is a perfect sock for bunion and hammertoe sufferers. The link below is describes The Tips for Bunion Care and includes these great socks. They help the first and second toes from touching which dramatically increases their stability, and can slow down the progression of bunions. 

http://www.drblakeshealingsole.com/2010/03/tips-on-bunion-care.html

Bunions and Hammertoes: Help with Home Products

HealthyToes Toe Stretchers, Small

If you read my post on Tips for Bunion Care you know that I love the product Yoga Toes or one of its many knockoffs. This is my lovely wife displaying her toes. She wears the product as a gentle stretch for her toes 30 minutes daily. It is not meant to wear walking, and you have to moisten the rubber to make it easier to slip on to your toes. Initially,  you may only be able to wear it for 5 minutes, then gradually build up the time. It should never hurt. Patients with narrow feet may have trouble fitting the fifth toe (I have had to cut out the partition between the 4th and 5th toes). One of my patients Barbara loved them so much that she brought them for all of her 6 children. It is not the only stretching to do for bunions and hammertoes, but they are definitely a big help!!

Athletic Injury Rehabilitation: The Law of Parsimony

Deception Point

The Law of Parsimony: When multiple explanations exist, the simplest one is usually correct.

This is my first post being inspired by the Mediterranean Sea along the coast of the Italian Riviera (this time from Diano Marina, Italy).

As I watched the Mediterranean Sea and read Dan Brown's Deception Point thriller, on page 238 he mentions the Law of Parsimony. This is a common law utilized in medicine; a good starting point in the treatment of injuries. I will use the Law of Parsimony in this post to describe the common starting point of treatment based on the commonest cause for several injuries listed below. If you have one of the injuries mentioned below, make sure that your treatment is addressing this issue.

• 
  
  Achilles tendinitis--tight achilles tendons
• 
  
  Plantar Fasciitis--inadequate arch support
• 
  
  Recurrent Ankle Sprains--weak peroneal tendons
• 
  
  Chondromalacia Patellae or Patello-Femoral Dysfunction--weak vastus medialis
• 
  
  Ilio-Tibial Band Tendinitis--tight Ilio-Tibial Bands
• 
  
  Morton's Neuromas--tight front area of your shoe or boot
• 
  
  Posterior Tibial Tendinitis--excessive pronation
• 
  
  Bunion Pain--tight front area of shoes
• 
  
  Metatarsal Area Pain--development/increasing of hammertoes (see post on Budin Splint)
• 
  
  Peroneal Tendinitis--lateral instability in shoes
• 
  
  Generalized Arch Pain--weak intrinsic foot muscles

These are great starting points to treat these injuries. In many cases, it will take awhile to get weak areas strong, tight areas flexible, and correct biomechanical and shoe issues. Other treatments will be used to address anti-inflammatory concerns, and less common causes of the same injuries at the same time to hopefully sped healing along. See the post on Tips for Bunion Care as a good example. Thank you Dan Brown and the Mediterranean Sea for this inspiration. Now off to a great pasta or seafood dinner.

Hammertoes and Metatarsalgia: Possible Help with Budin Splint

Dr. Jill's (Budin) Hammertoe SplintPedifix Toe Straightener #P55

If you develop pain in the front of your foot (toes or metatarsals), one of the most successful treatment modalities is a Budin Splint. It should be initially worn very loosely around the toe. It is worn walking, not sleeping, and can immobilize the toes enough to rest the injured area. Normally, combining a Budin Splint, sometimes called a Single Loop Hammertoe Regulator, with two to five times daily icing can make the symptoms diminish significantly. See the post on icing. The loop that goes over the toe can be used on the toe that seems to be the most painful, or connected with the metatarsal that seems to be the most painful, or on the toe next to it (although not the big toe), or over both toes by opening up the loop wider. These splints can be bought at many locations including Footsmart.com and mooremedical.com. After tightening the elastic band to comfort, cut off any extra material on the under surface of the splint that is not under the pad, and then use tape (any kind) to secure the band to the under surface. The splint should never be worn if it increases pain in any area.

They are commonly used in enclosed shoes, or in socks around the house, to prevent or slow down the development of hammertoes. The photo above also shows an additional metatarsal pad (purchased from www.Hapad.com) for extra metatarsal support. They are an excellent post hammertoe surgery splint worn for up to 2 years. If the splint slips around alittle since it initially may need to be on loose, place a small piece of tape on the elastic band attaching the band to the skin on top of the toe. Golden Rule of Foot: Place the Budin Splint as far back onto the toe, away from the toenail, as possible. The splint itself should never feel like it pulls the front of the toe downward which could cause a hammertoe. The underlying pad is one size fits all so feel free to trim the size down if it cuts into you or interferes with your orthotic device. You should be able to make it work. If you start out real loose for comfort, once a week slightly tighten the band an extra 1 mm (slightly). If you are wearing it for pain, wear it 2 months longer after pain subsides.

Another type of splint has 2 loops, a double loop hammertoe regulator.Budin Toe Splint - Double Toe - Model 65065 I do not like how it pushes the two and third toes apart, so I tell patients to place on the 2nd and 4th toes. The double loop can be tried if only partial success is achieved with the varietions above of the single loop. I sure hope you like these products.