Doctors generally define a foot deformity as any deviation from the ideal, physiological foot shape. Minor changes in the skeleton of the foot are very common nowadays. The most common cause is incorrect footwear, which puts strain on the feet, leads to pressure points and can therefore promote foot deformities. In the case of severe functional restrictions, correction is necessary, if necessary with the help of an operation.
Foot deformities are all changes to the foot that deviate from the ideal, healthy foot. The basis of such diseases are misalignments of the foot bones that are caused by incorrect weight-bearing or the wrong footwear.
Depending on when they occur, a distinction is made between primary (congenital) foot deformities, which are already noticeable in newborns and children, and secondary (acquired) foot deformities, which can occur later in life, e.g. as foot deformities in diabetes (diabetes mellitus). Rheumatic changes are differentiated from neurogenic foot deformities according to the cause (etiology).
Finally, doctors differentiate between foot deformities in daily practice on the basis of their appearance and the associated symptoms:
In addition, there are deformities of the toes, such as
Anatomy of the foot © bilderzwerg #54960419 | AdobeStock
The symptoms of foot deformities depend largely on the underlying deformity in the toes or foot. As a rule, pain on exertion or pain when walking occurs. An altered foot position or various avoidance movements and associated incorrect loading can damage the joints in the ankle or knee area and also cause further pain. Muscles and tendons adapt to this and, in the end, the entire gait of the affected person may change.
Misaligned toes such as hammer toe or hallux valgus, which often occurs in the area of the big toe on the outside of the foot, are particularly painful when walking and often cause sores due to the friction of the shoes. Over time, the hallux also causes the big toes and adjacent toes of the affected feet to lean inwards more and more. This condition is particularly common in older women.
Depending on the type and severity of the foot deformities or toe misalignments, walking and running becomes increasingly difficult and wearing shoes more painful.
Many foot deformities are noticeable after some time due to their conspicuous appearance, so that specialists can quickly identify them with a visual diagnosis.
For example, a barefoot patient with a hollow foot will show that the side of the foot is lifted up to two centimetres on the inside, i.e. no longer in contact with the ground. With flat feet, on the other hand, the entire former arch of the foot is now flat against the ground. The splayfoot, on the other hand, is characterized by metatarsal bones that are further apart.
In newborns and children or if the symptoms are unclear, an imaging procedure is used, usually an X-ray. This makes it very easy to visualize bone deformities in the foot skeleton that are not visible from the outside or bone cones, such as heel spurs or hallux valgus.
Imaging also has the great advantage that further treatment, e.g. surgery, can be better planned.
The treatment of foot and toe deformities depends on the type and severity of the deformity on the one hand, and on the respective symptoms on the other. Doctors differentiate between conservative and surgical treatment approaches.
In the majority of cases, specialists will first try to achieve conservative relief. However, depending on the patient's age and the length of time they have been ill, the options may be limited.
Conservative means above all using special insoles, pressure protection orthoses, wide footwear or even custom-made orthopaedic shoes. Foot exercises are another way to achieve relief, especially in the early stages of the disease. Doctors also often recommend simply walking barefoot, especially in summer, as this allows the feet to experience their natural environment and at the same time trains the senses.
In some cases, conservative therapy is no longer sufficient - especially if the symptoms become too severe, or walking is only possible to a limited extent or further joint damage occurs. In this situation, doctors often decide to carry out surgical treatment.
This involves correcting the deformity or reducing painful bony protrusions (e.g. hallux valgus, heel spur, hammer toe).
The possibilities of modern foot surgery range from minor corrections of deformities to bone removal and bone realignment. The latter is necessary if, for example, a hallux valgus needs to be straightened. In this case, the specialists attempt to bring several misaligned toes back into the correct position in relation to the foot skeleton.
Subsequent rehabilitation can also increase the chances of recovery.
Foot deformities are treated by orthopaedic specialists who specialize in hand and foot surgery. These can usually be found within special focus centers. You can recognize the experts before a consultation primarily by their proven experience and regular further training in their respective specialist field.
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