Feet come in all shapes and sizes. Length, width, arch height, toe length, and other factors can vary significantly from person to person. While there is no one “correct” or “normal” foot shape, the unfortunate truth is that some foot types are better than others at doing the work of keeping you standing, moving, running, and jumping comfortably and without pain.
A foot deformity is any foot shape or condition that varies enough from the normal, healthy range that it can cause problems or pain, either on its own or through throwing other joints or body alignment out of whack. These can be genetically inherited and present at birth, or they can develop over time due to environmental factors.
Congenital Pediatric Foot Deformities
Common congenital deformities present in children include flat feet, club foot, intoeing, out-toeing, cavus foot (high arches), and tarsal coalition, and even extra toes (polydactyly).
Not all congenital foot deformities are obvious right away. While there’s no mistaking a clubfoot, a child with flexible flat feet (in which arches flatten when standing or walking) or certain intoeing or out-toeing conditions may not exhibit any signs or symptoms until they begin walking.
Not all conditions need treatment, either; children are still growing and certain conditions generally improve on their own in time. However, you should always bring your child in for an initial evaluation to rule out more serious problems. While flexible flat feet, for example, generally tend to self-correct, more rigid flatfoot caused by tarsal coalition or other neuromuscular problems require much more aggressive care.
Acquired Foot Deformities
Generally speaking, foot deformities acquired in later childhood or adulthood are usually a consequence of wear and tear, injury, poor footwear choices, a related pre-existing foot deformity, or a combination of these and other environmental factors.
Treatment usually follows a two-step process. First, we’ll pursue conservative treatment options (such as orthotics, physical therapy, footwear modifications, etc.); the goal is to halt further progression of the deformity and alleviate the symptoms so that you can resume normal activities without pain. If conservative treatment has failed to adequately resolve your discomfort, we consider step two: surgery to correct the deformity.
Some common acquired foot deformities include:
Bunions or Bunionettes. The tip of the big toe (bunion) or fifth toe (bunionette) begins to drift toward the center of the foot, while the joint at the base of the toe moves outward, forming a enlarged bony bump.
Hammertoes, Mallet Toes, and Claw Toes. The tips of smaller toes (sometimes just one, sometimes all four) curl downward, while middle joints may arch upward. At first the joints retain flexibility (meaning you can pull them straight with your fingers), but in time become rigidly locked in place.
Adult-Acquired Flatfoot. Unlike congenital flat feet, which are flat from birth, adult-acquired flatfoot develops over time as arches collapse from wear and tear, injury, arthritis, or other factors.
Haglund’s Deformity. Also known as “pump bump,” this bony enlargement forms at the back of your heel near where the Achilles tendon inserts into the heel bone. It typically occurs in people who frequently wear hard-backed shoes (especially ones that don’t fit), such as pumps, ice skates, or men’s dress shoes.
Charcot Foot. A severe disfigurement of the foot involving multiple broken bones and damaged soft tissues, caused by repeatedly walking on, and further damaging, injured feet. This usually only occurs in patients with severe neuropathy—their nerves are so badly damaged that they can’t tell they’re walking on broken bones.
Other conditions include overlapping toes, hallux varus (the opposite of a bunion, where the big toe drifts out instead of in), and more.
With any deformity, it’s important to seek help immediately. Most of these conditions are progressive, meaning they will not get better on their own, and unless you take steps to counteract them they will get worse. Being proactive means less pain, fewer problems, and lower risk of surgery.
So don’t wait! If your foot shape is causing you problems, call Dr. Corey Fox at Massapequa Podiatry Associates in Nassau County, Long Island.