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Overlapping toes refers to a foot deformity where a toe turns inwards and then lies on top of the adjacent toe. The fifth or the smallest toe is usually the most affected. In some cases, the second toe can also be affected. This foot deformity can also be referred to as clinodactyly. However, clinodactyly is a broader term that also includes curled toes as well as other various conditions affecting the fingers and toes. It mainly occurs due to muscle imbalances as well as abnormalities in the feet.
Bunions are common causes of overlapping toes, especially when the condition occurs between the hallux and the second toe. When this happens, the second toe lacks space to move to the hallux. This results in the second toe rubbing against the shoe constantly. When this constant rubbing is not corrected, ulcers may form in the affected area. This foot condition is mostly observed in people with diabetes, since it causes vast muscle imbalances as well as nerve damage in the feet.
What Causes Overlapping Toes?
The main cause of overlapping toes is not clear. The deformity is present from birth. Some medical researchers believe that abnormal positioning of the foot during the fetal stage in the womb can be a reason. However, just like Morton’s Toe, heredity plays a big role. It has been observed to run in certain families. Therefore, when an infant is born with this condition, chances are very high that one of the parents or even both have this deformity. Overlapping toes, just like other foot deformities are also present at birth. When not treated, they may develop to become permanent deformities. However, in most cases, it tends to resolve itself with time. Other observable causes of overlapping toes include:
1. Abnormal foot arch may affect the biometrics of the foot which might result to toes overlapping.
2. Some diseases like arthritis may cause alteration of the toe joint, which may lead to overlapping of toes.
3. Bunions, which mainly affect the big toe may bend and push the adjoining toe, leading to overlapping.
4. Malunion toe fracture.
5. It can also be caused by Tetany. This is a condition created by calcium deficiency, making the toes to overlap onto the adjacent one. However, this condition is temporary, and the toes are able to resume their normal position within a short time.
6. People who wear high-heeled shoes with narrow toe boxes are also at risk. Due to the narrow toe box, the toes don’t have enough space, and they may tend to sit on one another, in order to fit.
What Are The Symptoms of Overlapping Toes?
Overlapping toes can affect any gender. They are easy to notice, even without any diagnosis. People with this foot deformity tend to have common symptoms. If you have overlapping toes, here are some of the symptoms.
1. Walking with an awkward gait.
2. Pain as a result of irritation due to rubbing of the second toe against the shoe.
3. Callosities and corns developing on the surface of the toe due to the constant friction when the overlapped toe rubs against the shoe.
4. Some patients suffering from overlapping toes may also develop fungal infections especially between the two toes. This is due to the limited breathing space between the two toes. Fungi thrive in such places.
5. Difficulty wearing shoes since the overlapped toes seem to obstruct proper slipping in of the shoe.
How Are Overlapping Toes Diagnosed?
During diagnosis, the doctor will first examine the affected toe. After that, the physician will seek to determine whether there is a family history in relation to the condition. The doctor may also seek to know whether there is another family member with this foot deformity. Such information will help the physician to determine whether the condition is due to heredity. The physician will also assess the type of shoes that you wear. Once it has been established that one toe is above another one relative to their position on the foot, the diagnosis of overlapping toes can be confirmed.
How is Overlapping Toes Treated?
Overlapping toes and other foot deformities need correction since they tend to re-position themselves. The condition should be addressed as early as possible, so that it does not spread to other areas or cause further damage. This condition can be treated through conservative means and surgery. The treatment method applied depends on the extent of the problem. If it has been present for a long time, then it might be very hard to correct using conservative means.
Non-surgical treatment of overlapping toes involves proper shoe selection. The selected shoe must have a high and wide toe box to give enough room to the deformity. This also minimizes pressure on other toes. There are numerous types of padding available in footwear stores. You can experiment with as many as you want, as long as they are not treated. You will eventually find one that meets your needs. The reason why you should avoid treated pads is that they contain a certain acid compound. This acid tends to eat away any corns present on your feet. Once they are done with corns, they spread to the healthy skin, leading minor ulcers. If the problem occurs during birth, it can be corrected by stretching the toe passively, then applying adhesive tape. This helps to correct the problem after a certain period. Positive results can be observed within 6 to 12 weeks. Use of toe separators and toe straighteners can also be used to align the toes in the correct positions.
Conservative treatment methods are only effective when the deformity is still new while the toes are still flexible. However, if the deformity is old, and the toes have become rigid, the next option will be use of surgery. During the surgical procedure, the soft tissues and the tendons surrounding the affected toe are released. In some instances, placement of wires and pins may be necessary, to position the toe in its correct anatomical position. This hardware placement is done for around 4 weeks and then removed. The patient is then allowed to recover, and advised to avoid any form of weight bearing on the affected foot. Any movement could undo the surgery or even move the pin to a different location.
Best Shoes for Overlapping Toes
If you have Overlapping Toes and you don’t intend to seek surgical correction, then you only have one option. That option is wearing the right type of shoes. When choosing shoes, ensure that they have additional depth while the toe box is roomy enough. This will ensure that the toes are not cramped for room and they can stay relaxed. You should also look out for shoes whose upper material can stretch. Stretching will allow your overlapping toe to remain relaxed, without excessive friction and rubbing against the shoe.
Similar to most toe deformities, overlapping toes do not cause pain in infants and small children. It tends to correct itself with time, without the need for medical intervention. However, problems might occur with age and the problem becomes a permanent deformity. If the victim starts experiencing pain, medical intervention will be necessary.