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By Dr. Kuvent, April 30, 2009 12:31 pm

Our feet are incredible structures, and the lesser toes are no exception. Just as your thumb opposes and works opposite the smaller fingers in your hand, the lesser toes of your foot help to balance your body by working opposite from your “hallux” or big toe. Accordingly, in a healthy foot, specialized intrinsic muscles work on specifically the four small toes to allow them to stay aligned and function properly. However-as one might suspect-these toes can experience a unique set of symptoms.

Hammertoes are the most common and well-known digital deformity affecting the lesser toes. They typically will affect a single toe and will cause it to bend such that the first part of the toe is bent upwards, and the second part of the toe (the part with the toenail) is bent downwards. The typical signs and symptoms may include a corn on top of the joint where the toe bends as well as a callus underneath and behind the toe where it bears weight. Common causes of a hammertoe include tight shoes or stockings, biomechanical problems, or simply a long second toe.

A cousin to the hammertoe is the “claw toe” deformity. Whether our lesser toes are healthy or not, they typically consist of three small bones and two joints. With claw toes, not only is the first part of the toe bent upwards, but both the joints in the toe are also bent so that the second part of the toe tends to bend or curl downwards in a claw-like manner. This scenario is often associated with a cavus or high-arch foot type and neuromuscular disorders. It typically affects all the lesser toes at once, and may even affect the hallux.

In a “Mallet toe” deformity, the toe is strait except for the very end of the toe which is bent downwards. This tends to put pressure on the skin at the tip of the toe and will often lead to a callus formation there. The toenail will often become thickened and look as though it has a fungal infection. This condition is commonly associated with a long toe.

Numerous other conditions can also affect the lesser toes. “Curly toes” will typically bend downwards and underneath adjacent toes. They will often occur simultaneously on both feet. An overlapping 2nd toe will bend back and over the hallux, while both the 4th and 5th toes can be affected such that they may bend and rotate beneath the adjacent toes. Finally, a “floating toe” is commonly observed in a congenitally short toe which cannot purchase the ground.

Of course, each of these conditions has a unique set of symptoms, prognoses, and treatment options. Visit your podiatrist for an in-depth evaluation and discussion.

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By Dr. Kuvent, April 10, 2009 3:43 am

Preventing Prom Shoe Pain

As spring time rolls around, thousands of high school students and parents are no doubt highly anticipating that big event of the year: Prom. Many girls look forward to this night as a huge event in their high school years and hope to fill it with lots of great memories. There are, of course, many logistical preparations to make, but finding the right pair of shoes is truly critical in making this night a success.

Prom shoes on average cost $50-80, although there are many discounts available and shoes to fit any budget. A big issue is finding the right compromise between style and comfort. Many girls want to find shoes that look great, but heels that are too high can be a simple cause for a ruined Prom. The standard heel heights are usually 2”, 3”, and 5”, but it’s strongly recommended that girls choose a heel height similar to what they’re used to wearing on a daily basis. Consider your date’s height and how much you intend to dance. Both should be important factors when choosing high-heeled shoes.

If you’re not comfortable with heels, basic flats or wedge shoes may be a good substitute. These should be chosen as an alternative to kicking off heels later in the evening because many gowns are hemmed to floor length, and going barefoot will cause the dress to drag along the ground. Therefore, it’s also a good idea to have the shoes available at your first dress fitting so as to minimize alteration costs by maintaining a consistent hemline.
Since our feet actually swell during the day, it’s a good idea to go shoe shopping in the afternoon or evening to find a pair that will fit your feet most comfortably. Wear the shoes around the house for a few days prior to the big night in order to allow them to conform to your feet. Also, consider the Prom location and floor surface. You may want to scuff the bottoms of your shoes with sandpaper for more traction to make walking and dancing easier.

With simple planning and foresight, you can choose a pair of shoes that will leave an impression on your friends, family, and date-NOT on your feet!

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By Dr. Kuvent, February 12, 2009 10:52 am

Most commonly, heel pain is caused by inflammation of the plantar fascia — the tissue along the bottom of your foot that connects your heel bone to your toes. The condition is called plantar fasciitis.
Plantar fasciitis causes stabbing or burning pain that’s usually worse in the morning because the fact that the fascia tightens overnight. Once your foot limbers up, the pain of plantar fasciitis normally decreases, but it may return after long periods of standing, increased activities or after getting up from a seated position.

Plantar fasciitis usually develops gradually, but it can come on suddenly and be severe. And although it can affect both feet, it more often occurs in only one foot at a time. Be alert to; sharp pain in the inside part of the bottom of your heel, which may feel like a knife sticking in the bottom of your foot. Heel pain that tends to be worse with the first few steps after awakening, when climbing stairs or when standing on tiptoe. Heel pain after long periods of standing or after getting up from a seated position. Heel pain after, but not usually during, exercise Mild swelling in your heel

Under normal circumstances, your plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot. But, if tension on that bowstring becomes too great, it can create small tears in the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed. The causes of plantar fasciitis can be:

Physical activity overload

Plantar fasciitis is common in long-distance runners. Jogging, walking or stair climbing also can place too much stress on your heel bone and the soft tissue attached to it, especially as part of an aggressive new training regimen. Even household exertion, such as moving furniture or large appliances, can trigger the pain.

Arthritis

Some types of arthritis can cause inflammation in the tendons in the bottom of your foot, which may lead to plantar fasciitis.

Faulty foot mechanics

Being flat-footed, having a high arch or even having an abnormal pattern of walking can adversely affect the way weight is distributed when you’re on your feet, putting added stress on the plantar fascia.

Improper shoes

Shoes that are thin-soled, loose, or lack arch support or the ability to absorb shock don’t protect your feet. If you regularly wear shoes with high heels, your Achilles tendon — which is attached to your heel — can contract and shorten, causing strain on the tissue around your heel.