We may not think of our toes as being important -- but in fact, they are important to healthy foot functioning. Our toes, like other parts of the feet, are complex structures that absorb ground pressure and help us balance as we walk and run. Many of the problems that affect toes are caused by abnormal foot anatomy. Over time, these abnormalities may lead to permanent changes in a toe's appearance, such as a hammer toe or a bunion.
A bunion is a large bump on the side of foot, just below the big toe joint. It's the result of the big toe shifting out of position over time, nudging ever closely to the second toe. This is the result of a gradual separation between the first and second metatarsal bones (long bones of the foot). These changes in bone positioning are most often due to abnormal foot function. For example, people with flat feet are more prone to bunions. This can cause a widening of the foot and a large (and often red) bump on the side of the big toe joint. Problems often associated with a bunion include pain at the bump area, difficulty fitting into shoes due to the widened foot, and painful calluses on the soles of the feet.
The foot pictured to the left has two types of bunions, one at the big toe and one at the area of the pinkie toe. A tailor's bunion is a bunion that is present on the pinkie toe side of the foot. Similar to a bunion on the big toe side, this type of bunion also has the characteristic bump -- although it is smaller, which is why it is often called a "bunionette." A tailor's bunion affects the joint area of the fifth metatarsal bone, where it meets the pinkie toe. It usually results in the pinkie toe pressing against the 4th toe, sometimes curling under it. A tailor's bunion often causes pain, shoe discomfort, and callus formation on the sole of the foot. Having an abnormally shaped 5th Metatarsal bone or abnormal foot functioning that puts excess pressure on the outside of the foot can lead to tailor's bunion. As for the funny name? It's from the notion that tailors often sat in a cross-legged position, putting pressure on the outside of the foot.
A hammer toe is an abnormally shaped toe that is pulled back and upward in relation to the other toes. It most often affects the second toe and frequently occurs when there is a bunion at the big toe. People with flat feet are also prone to hammer toes. Hammer toes are the result of abnormal pulling of foot muscles, which occurs when there is abnormal foot functioning. Problems that often occur with a hammer toe include painful corns on the top of the toe, calluses on the ball of the foot (under the hammer toe), and arthritis of the toe joints.
Hallux limitus is the medical term for restricted motion at the big toe joint (first metatarsophalangeal joint). For the feet to function properly while walking, a certain degree of flexibility of the big toe joint is required. Hallux limitus is caused by decreased range of motion at the big toe joint which can progress to arthritis and a complete loss of range of motion, known as hallux rigidus. Symptoms include pain at the big toe joint, a bunion (bump) at the top of the big toe joint, and a callus on the side of the big toe. Hallux limitus can be caused by abnormal foot anatomy or a previous history of trauma, such as turf toe or toe fracture.