Retracted toes can best be described as abnormal flexion at both toe joints and extension at the metatarsal phalangeal joints. The ends of the toes do not contact the ground due to the extensor tendon on the top of the foot pulling them back.
Retracted toes can increase the vertical pressure on the metatarsals resulting, in some cases, of pain from the sole of the foot.
The causes of retracted toe are:
- Inappropriate footwear
- Flat feet
- Highly arched feet
- Hereditary factors
- Long second toe
- Various diseases e.g. rheumatoid arthritis
Symptoms of retracted toes:
- Retracted toes can be subject to cramping and on occasion can cause cramping within the foot or even the leg
- A corn may form on top of the toe as a result of pressure from a shoe or on the end of the toe
- Bursitis that is inflammation of a small sac of fluid under the skin and overlying the joint. The top of the joint will appear red and swollen
- Ulceration can form particularly where the circulation is reduced
- Infection can be a complication of retracted toes particularly where general health is not good
Treatment and advice for retracted toes:
- Consideration of footwear is very important. A deep toebox with soft leather uppers is ideal. With certain medical conditions customised shoes are often required
- Good fitting hose which is not restrictive is advised
- Certain types of felt padding can be used to reduce pressure loading
- Applying an appropriate moisturising cream is often helpful
- The use of silicones, which can be purchased pre-packed in the form of tubes
- Podiatrists can mould silicone rubber to the toes, which is often very successful. For example a silicone prop to the second, third and fourth toes
- Routine footcare to address corns and callouses
- Specific footcare for episodes of bursitis, ulceration or infection associated with retracted toes
- Consideration of a surgical procedure such as an arthroplasty for a permanent solution.
- Where there are retracted toes and they are associated with biomechanical factors, orthoses can be very helpful in assisting with re-alignment, particularly for flexible retracted toes.