Orthopedics-Online

The splayfoot / splayfoot

definition

The splayfoot is the most common acquired foot deformity or malposition. It almost always arises due to genetic makeup and affects more women than men. The lowering of the transverse arch of the foot leads to foot complaints with widening of the forefoot, which means that the entire forefoot comes into contact with the ground.

Synonyms

Splay feet
splayfoot
Pes transverso planus
hallux valgus
Hallux rigidus
Pain in the foot and sole of the foot

Causes of splayfeet

A splayfoot can develop as an aging process without any external influence.

With age, the fat pads under the 3 middle phalanges of the toes disappear. This increases the pressure on the bones below. The splayfoot is also favored by long years of wearing high-heeled shoes. These narrow the toe of the foot and five times the pressure on the toe due to the changed weight distribution.

Women are also often genetically predisposed, as they tend to have weak connective tissue. Long-standing high-heeled shoe wearers are therefore the greatest risk group for developing splayfoot in old age.

You can find out more about the causes of this foot deformity here: Causes of splayfeet

Symptoms

The main symptom is exercise-related pain. These occur particularly when walking and standing and decrease when the patient is resting. The widening of the foot causes discomfort in the shoe.
Due to the changed position of the metatarsophalangeal joints (hammer toes or claw toes) corns (clavi / clavus) appear over the toes.

Another consequence is that the big toe pushes itself outwards (hallux valgus), while the little toe moves inwards (digitus quintus varus). The flexor tendons in particular become too short as the foot spreads further and further, and the toes are pushed into a claw position.
Hammer or claw toes develop.

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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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60311 Frankfurt am Main

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Splayfeet pain

Splayfeet can cause very severe pain.

The reason for this is a profound change in the structures in the foot and the adjacent tendons.
The lowering of the arch causes the foot to widen. This broadening needs - for example in the shoe - Much more space than usual.

The anatomical widening of the foot is not taken into account in commercially available footwear. Shoes that once fit now cause pressure pain on the outside and newly purchased shoes are too tight for the splayfeet.
The constant pressure on the outside of the feet leads to what is known as metatarsalgia. This is how the appearance of pain under the heads of the metatarsal bones is called. The metatarsal bones form the connecting piece between the toes and the metatarsal bones on the foot.
The middle three metatarsals are particularly affected. Patients then express pain in the front, middle third of the foot, as well as increased callus formation.

The pain increases, especially under stress, as the body weight exerts additional pressure on the arch of the foot. The tight shoes already mentioned present an additional problem:
Since the tendons can be displaced by the lateral constriction, the toes can be displaced. The tendons pull on the toes as extensions of the foot muscles and over time bring them into a crooked position. After the toe bones have also been relocated, dislocations in the toe joints can occur. These are associated with extreme pain and need orthopedic care as soon as possible.
NSAIDs are usually prescribed for pain in splayfeet, i.e. painkillers that are not covered by the Narcotics Act. These have relatively few side effects and can fight the pain well.

However, in addition to symptomatic therapy, causal therapy must also be carried out, as long-term use of painkillers cannot be a solution. If taken for a long time, these cause also stomach damage and must therefore always be combined with a stomach protection (e.g. Pantoprazol®). To relieve the pain, it is primarily advisable not to wear tight shoes and to regularly walk barefoot. This should at least be possible at home.

Ultimately, however, freedom from pain can only be guaranteed through orthopedic care.

You can find more about splayfoot pain here: Splayfoot pain

Appointment with ?

I would be happy to advise you!

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

diagnosis

The diagnosis splayfoot can be made from the symptoms and the physical examination.
Due to the deformities described, there is a pathological callous pattern over the 2nd and 3rd metatarsal bones. The examination findings include:

Examination while standing: The forefoot is widened and the transverse arch sinks.
Examination while seated: characteristic calluses and corns can be seen on the sole.
An X-ray can provide further information. Here you can see a changed angle between the 1st and 2nd metatarsal bones, as well as the fanning out of the metatarsus (splayfoot).

therapy

A permanent erection of a sunken transverse arch can usually neither be achieved with conservative nor with surgical measures. To treat the foot deformity, conservative measures are taken, while accompanying toe deformities are corrected surgically.

The different therapy concepts are:

Avoid too tight and too high shoes
Immobilization, contrast baths, anti-inflammatory drugs and pain relief drugs
Relief of the pressure points via a retrocapital splayfoot insert

Do you possibly get a deposit? You can find more general information here: Insoles for shoes.

Exercises

The foot muscles can be actively strengthened through specific exercises. The focus of splayfoot gymnastics is the structure of the longitudinal and transverse arches. It is advisable to train barefoot! Of course, every exercise should only be practiced as long and as intensely as your general constitution and state of health allow.

Stand on tiptoe several times a day and slowly circle your feet. The heels must not touch the ground. At the beginning you can start with 10 repetitions on both sides, but in the course of the training an increase to at least 20 repetitions is desirable. It is not uncommon for the foot to 'crack' the first time! This exercise is ideal to incorporate into everyday life to save time: For example, you can Strengthen the foot muscles at the same time when making a phone call or brushing your teeth!
For this exercise you will need a thin stick, e.g. a pencil. Now stand carefully on the stick and let it roll slowly from your heel to your toes. Each side is repeated several times.
In this exercise you will again use a staff. Claw the toes of one foot into the ground so that the sole of the foot floats above the ground and forms a kind of bridge between the heel and toe. Now stop touching the stick with the sole of your foot and slide back and forth with small movements, still without touching the stick. Repeat several times on both sides!
Now try to grab the stick with your toes. If simply lifting the stick works well, you can try to hold the stick longer and e.g. put in an adjacent box. This exercise is well suited for children with splayefoots, as it can be easily designed in a playful way: Instead of the stick, you can choose colored marbles of different sizes, which have to be placed in different colored pots, etc.
You need a small ball for this exercise. You stand on the ball and actively push it backwards with the help of the muscles of the foot. It is advisable to start at the front of the toes and continue backwards. Make sure you perform the movements slowly and in a controlled manner!
The following exercise must be completed while sitting. To do this, lift your legs and clamp the small ball between the balls of your feet. Now carefully transport it towards the heel without the ball falling off. It is possible that this exercise may put strain on the calf muscles. To prevent muscle spasms, give your calves a gentle shake after each repetition.
In this exercise, a thin towel or a small scarf is spread on the floor. Now grab an edge with your toes and pull it towards your foot with small claw movements. To increase the intensity, a thicker towel, e.g. from terrycloth.
Now you try to grab the towel with your toes and lift it up.

Would you like to find out more about exercises and physiotherapy? Here you will find more information: Physiotherapy for foot malpositions and Exercises for misaligned feet.

surgery

A Surgery to correct splayfeet should only be arranged very cautiously! The operation is problematic insofar as the foot does one functioning whole unit represents. All parts interact with each other and every small bone has its exact place. If the position of the Metatarsal bones or Toe bones If corrected individually, the entire statics and mechanics of the foot can change.

In particularly stubborn and painful cases of splayfeet, an operation still offers the Possibility of recovery. However, only if the patient has already been patiently over a long period of time conventional treatments (physiotherapy, Splayfoot insert) were applied without success. Usually this applies to stiffened (contractile) Splayfeet caused by severe changes in the Joints Marked are.

There are different surgical options, most of them will be Parts of the metatarsal bones severed in a targeted manner. This procedure is also called Osteotomy.

Often parts of the middle metatarsal removed with the aim of lifting the painful heads. But the procedure is delicate: if the lift is too high, it creates a very painful overload! In technical jargon, the resulting pain is also referred to as'Transfer complaints‘.

Furthermore, a so-called subcapital (located below the head) Osteotomy be made. Here the bone below the metatarsal head is severed and with small ones Screws or Wires fixedso that the heads are shifted backwards.

In particularly severe casesIf the affected person can barely walk and the pain is unbearable, the last option is a complete removal (Resection) of all metatarsal heads. To do this, all heads are shortened to the same height, so that an even line is created. In many cases, the pain is reduced after the operation and the patient can walk again symptom-free.

Very often occur with splayfeet Misalignment of the toes (Deformities), e.g. in the context of Hammer toe or Hallux vagus (The big toe moves sideways). Therefore, when choosing the surgical method, this part of the Foot malposition get noticed.

Deposit supply

Insoles can help treat splayfoot and relieve pain. The shifted balance of forces in the arch of the foot is compensated for by insoles. They serve to simulate the original anatomical position and thus restore a natural weight distribution.

However, deposits should always be professionally adjusted and not be purchased at a flat rate over the Internet. An insole must be 100% adapted to the foot, otherwise the problem will worsen and lead to even greater pain and damage. Suitable insoles can be found in specialized shoe stores or shops for orthopedic needs.
Adjustments and advice can also be made there.

Orthopedic insoles, such as those used with splayfeet, are slightly more expensive than conventional insoles. They are in the range of € 30-150 per couple. However, for reasons of hygiene, several pairs should be purchased. The insoles can relieve pain, especially in the initial stages, and prevent further deterioration. In very advanced stages, however, it is usually not enough to use insoles alone; surgical therapy is usually necessary in these stages.

Read more on the topic: Insoles against splay feet