Introduction
Having an overlapping toe on one or even both feet is quite common. Overlapping toes are mostly inherited but sometimes can also happen from wearing very tight shoes or having some underlying condition. The toe that is the most commonly affected in this case is the last one, the pinky, but the big and second toes can also be involved. Everyone can be affected by this, irrespective of age and gender. Some individuals even have one or more overlapping toes by birth or can develop over time. About two to three percent of newborns are affected by overlapping toes.
What Are the Causes of Overlapping Toes in Adults?
Overlapping toes can be both inherited and result from tight footwear or the biomechanics of how individuals walk. Talking about them in detail:
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Hereditary Factors - Many people are born with overlapping toes. One might inherit this type of bone structure in their feet, later leading to an overlapping toe. Morton's toe, which is basically a longer second toe, is also associated with overlapping toes.
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Tight-Fitting Uncomfortable Shoes - If someone is wearing shoes with a very small or too tight toe box, it can result in forcing their toe a little out of the line. Wearing high heels or pointy-toe shoes leads to overlapping of the toe.
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Arthritis - Joint inflammation and stiffness in feet caused by arthritis leads to a change in the alignment of the toes. Rheumatoid arthritis is one type of arthritis that is capable of changing the foot structure by causing bunion and big toe overlapping.
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Biomechanics - The posture and the way individuals walk have a huge impact on their feet and toes. Overpronation, which is basically when the foot rolls inwards a bit too much, is also associated with overlapping toes and the formation of bunions.
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Injuries - Injuries like dislocated joints can also result in overlapping toes.
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Position of the Fetus- Many studies have shown that the position of the fetus inside the womb during development can also affect the position of the toes.
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Hammer Toes - If the toes are bent in the form of a hammer, it is called hammer toes. It can also lead to overlapping toes.
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Flat Feet - The normal biomechanics of the foot get altered by high arches or flat feet in children, which unfortunately lead to overlapping toes, mostly affecting the fifth one.
What Are the Problems That Overlapping Toes Can Cause?
Overlapping toes can cause a series of problems. Some are:
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Pain and Irritation - This is the biggest symptom of all. Overlapping toes causes immense pain along with inflammation and irritation of the toes when the toes are rubbed together or against the side of the surrounding shoe.
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Corns - If one has overlapping toes, it is very common for them to develop corns on their feet. Corns generally develop because of the friction between the toes. Corns can lead to underlying wounds in extreme cases and can also cause ulceration if the patient is diabetic or has peripheral vascular disease.
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Footwear Issues - The shape and size of the feet get heavily distorted due to overlapping toes which gradually makes fitting into normal shoes difficult. In extreme cases, the patient starts wearing custom-made shoes or shoes with extra depth footwear.
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Unnatural Gait - Gait often gets affected because of the pain inflicted by overlapping toes. People generally would prefer to walk in a way they can avoid the pain that further can compromise the gait and later lead to other problems.
How Can Overlapping Toes Be Diagnosed?
For diagnosing overlapping toes, a podiatrist or a foot and ankle surgeon first goes for the physical examination of the patient, followed by some diagnostic tests. Diagnostic tests are important because viewing the bones and structure of the foot is immensely necessary for proper diagnosis. X-rays are mostly used by doctors to see the bones of the foot. Doctors also opt for magnetic resonance imaging tests to analyze the location and structure of the ligaments. Multiple types of diagnostic tests enable doctors to accurately diagnose patients and prepare for treatment. Since the anatomy of every individual is different, it is important for surgeons to carry out various tests for proper planning, even in cases of rare abnormalities.
How Are Overlapping Toes Treated?
The treatment generally depends on the age of the patient and also the factor causing overlapping toes. The treatment is, however, different for newborns and adults.
In the case of newborns, some conservative measures can be followed for correcting overlapping toes like :
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According to a study conducted in 2007, among a group of 44 newborns with overlapping toes, 94 percent of the babies were seen to improve and were cured after six months of simply taping the toes in a straight position.
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Gentle stretching and using toe spacers also prove to be quite effective in the correction of overlapping toes in newborns.
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Starting the treatment early is always the best choice. If the treatment is started even before the child begins to walk, healing would be faster, or else the toe might become rigid and require corrective surgery.
In the case of adults, conservative methods like using toe separators, pads, and inserts or wearing splints are found to be immensely effective. Opting for physical therapy has also been found to be helpful if the tight muscles and tendons are involved in causing overlapping of the toe. So it is always advisable to do physical therapies recommended by the physical therapist.
Surgeries are recommended when the conservative measures do not seem to work and do not provide relief to the pain or fail in straightening the toes. Surgeries are generally conducted to correct a severely overlapping pinky toe and a big toe with a bunion.
Conclusion
Overlapping toes are quite common and curable. It is always important to see a board of certified foot and ankle specialists before jumping into any decision about the surgery because if there is any underlying cause, only doctors can find them out.
