Fingers and toes represent the masterful engineering of mother nature found in human and primate anatomy. For simplicity, toes are the focus today, but their design is alike.
Toes are made up of three bones called phallanges (sing. phallanx), except the hallux or big toe, which only has two. Where the toe meets the foot forms a "knuckle." Thus, the average toe has three knuckles, one nearest the foot, one further away, and one in the middle.
Toes flex, like when grabbing a shag carpet barefoot, and they extend, as when releasing the carpet fibers. Each toe bone is flexed or extended by specific muscles.
Claw toes resemble a claw formation, whereby the distal two knuckles are flexed and the base knuckle is extended. The toes are "scrunched up," with the tips pressing against the ball of the foot. The base knuckle is frozen in extension, elevating the middle phallanx so that it frequently rubs the roof of a shoe during gait.
Hammer toe deformity is when the toes are stuck with the middle knuckle flexed and the others extended. In this circumstance, the middle toe knuckle is arched up by itself.
Mallet toes, while rare, occur when the distal knuckle is frozen in flexion.
Each of the abnormalities listed above are the result of a muscular imbalance between flexor or extensor muscles. If the muscles on one side are weak (inhibited), then the opposing muscles are relatively tight. Add cramped shoes to the equation, year after year, for over 6,000 steps a day, and voila: the toe gets stuck in a particular deformity. The deformity then rubs within the shoe and can form corns or other complications. What determines whether it is a claw or hammer that forms?
It is essential to understand the anatomy to find the answer. Each set of muscles has a particular anatomy, from different nerves, different cord levels of the spine and coursing along different routes.
Claw toes occur when the long extensor muscles of the distal phallanges are not maintaining the proper tone. Their "weakness" can be the result of many causes, all of which interfere with the brain-muscle connection or muscle anatomy. The differential diagnosis would include L4-5 misalignment, sacroiliac joint dysfunction, a posterior fibular head, or ankle problems of any kind.
The differential diagnosis for hammer toes would be the same, but the priority of where to look first as a clinician would be altered because different muscles are involved.
The optimal approach to these problems is to seek out a chiropractic applied kinesiologist. These professionals can test the involved muscles and correct inadequacies. Treatment may include spinal and extremity adjustment, acupuncture/acupressure, dietary counseling, gait and shoe evaluation, and possibly orthotics. Orthotics should only be considered after all other corrections have reached a maximum medical benefit. To get more information or find an AK doctor near you, visit the International College of Applied Kinesiology (ICAK) online.
Toes are made up of three bones called phallanges (sing. phallanx), except the hallux or big toe, which only has two. Where the toe meets the foot forms a "knuckle." Thus, the average toe has three knuckles, one nearest the foot, one further away, and one in the middle.
Toes flex, like when grabbing a shag carpet barefoot, and they extend, as when releasing the carpet fibers. Each toe bone is flexed or extended by specific muscles.
Claw toes resemble a claw formation, whereby the distal two knuckles are flexed and the base knuckle is extended. The toes are "scrunched up," with the tips pressing against the ball of the foot. The base knuckle is frozen in extension, elevating the middle phallanx so that it frequently rubs the roof of a shoe during gait.
Hammer toe deformity is when the toes are stuck with the middle knuckle flexed and the others extended. In this circumstance, the middle toe knuckle is arched up by itself.
Mallet toes, while rare, occur when the distal knuckle is frozen in flexion.
Each of the abnormalities listed above are the result of a muscular imbalance between flexor or extensor muscles. If the muscles on one side are weak (inhibited), then the opposing muscles are relatively tight. Add cramped shoes to the equation, year after year, for over 6,000 steps a day, and voila: the toe gets stuck in a particular deformity. The deformity then rubs within the shoe and can form corns or other complications. What determines whether it is a claw or hammer that forms?
It is essential to understand the anatomy to find the answer. Each set of muscles has a particular anatomy, from different nerves, different cord levels of the spine and coursing along different routes.
Claw toes occur when the long extensor muscles of the distal phallanges are not maintaining the proper tone. Their "weakness" can be the result of many causes, all of which interfere with the brain-muscle connection or muscle anatomy. The differential diagnosis would include L4-5 misalignment, sacroiliac joint dysfunction, a posterior fibular head, or ankle problems of any kind.
The differential diagnosis for hammer toes would be the same, but the priority of where to look first as a clinician would be altered because different muscles are involved.
The optimal approach to these problems is to seek out a chiropractic applied kinesiologist. These professionals can test the involved muscles and correct inadequacies. Treatment may include spinal and extremity adjustment, acupuncture/acupressure, dietary counseling, gait and shoe evaluation, and possibly orthotics. Orthotics should only be considered after all other corrections have reached a maximum medical benefit. To get more information or find an AK doctor near you, visit the International College of Applied Kinesiology (ICAK) online.
About the Author:
Charles Leahy writes about alternative healthcare. Find a great glen ellyn chiropractor, and learn all about applied kinesiology.
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