What could cause an improperly chosen shoe?

14-06-2018

A wrong shoe, besides the instantaneous pain and discomfort, could cause serious foot deformities on a long term. Our blog entry will help you how to choose the proper shoe to prevent bunion and hammer toe.

What is a bunion?

Bunion (hallux valgus) is one of the most common deformities of the foot. It is a bony growth that forms on the joint at the base of the big toe.

Normally the big toe is parallel to the other toes, but if, the big toe bends towards the small toes, a painful lump forms on the inner part of the foot, at the base of the toe. As a result, the springs and supporting function of the big toe are deteriorated.

Rarely, smaller bunions could form on the joint of the little toe too. It is called bunionette or tailor bunion.

What is a hammertoe?

Hammertoe (digitus malleus) is a foot deformity of the proximal interphalangeal joint that forms an abnormal bend in the middle of the toe, resembling a hammer. Usually occur on the second, third and fourth toes.

Why do bunion and hammertoe form?

Both bunion and hammertoe are formed due to the decomposition of the foot’s structure, which is often caused by a wrong shoe.

The median of our body normally focuses at the heel bone. Even a 1 cm high heel could change the center of mass, it could move it towards the toes that increase the load of its joints and muscles.

Bunions form mostly because of an incorrect foot structure. Due to the flattening of the transverse arch, the foot is widening. This indicates the muscles of the big toe to pull outwards the proximal phalange of the big toe. Therefore, the most frequent reason of the deformity is an inadequate shoe, which could cause the collapsing of the transverse arch and the clamping of the toes.

Too high heels force the mass center on the forefoot, changing the pressure on the sole, which can be worsened with a tight fitting shoe. If the balance of the foot is disrupted and the load is focused on the base of the toes, the big toe starts to bend towards the small toes and a bony growth forms at the joint. The bent big toe pushes the small toes closer, they have less space and therefore they take up a bent position. Having the toes bent for a long time can cause the muscles in them to shorten, resulting in the hammer toe deformity.

In our body everything is connected with everything, none of the joints or muscles are functioning without another. If the balance is disrupted, the body starts to compensate it by activating other muscles, therefore a wrong shoe on a long-term could cause pain in the knee, hip and in the back too.

How to prevent the formation of a bunion or a hammertoe?

The prevention starts with the right shoes. The perfect shoe for the foot doesn’t clamp the toes, let them free movement, and long and wide enough to not reach the toes the tip of the shoe. The ideal shape is rounded, where the toes fit comfortably, pointed toe is absolutely avoided. Be sure to choose a flexible sole, so the foot can move easily while walking.

Regarding the height of the heels, neither too high, nor completely flat is recommended, the ideal heel height is 2 cm. High heels force the foot to an abnormal position that changes the center of mass and increases the load of the metatarsal and tarsal bones. After a while, this could lead to periostitis, hairline crack or fracture.

Anatomically wrong shoe effect on the weight distribution and stability of the whole body and like this, it could cause back or low back pain. To compensate the focus of the center of mass, antalgic back bend occurs at the lower part of the spine, which causes tenseness in the muscles of the back and waist. This is why the occasional wearing of high heels could cause back pain.

As a prevention, foot strengthening exercises are recommended as well, which can be easily acquired from a physiotherapist.

What should I do if I have a bunion or hammertoe?

It is important to know, that a smaller deformity can be treated more easily to an advanced, so if the deformity is already visible, visit an orthopedic specialist as soon as possible. The specialist determines the progression of the lesion and proposes treatments depending on the progression.

In an early stage, both for bunion and hammertoe, toe splint for the night and day use of silicone protectors or separators might be to correct the angle of the toes and ease the pain.

Bunion or hammertoe surgery is recommended, if the conservative therapy was not effective, the caused complaints (pain, esthetic problem) worsen the patient’s quality of life significantly, or the deformity cannot be corrected in any other way.