Though it’s a common foot problem, the deformity known as splay foot isn’t given as much attention as it deserves. More and more people are being diagnosed with the foot condition, which is characterized by the metatarsal bones of the foot spreading and making the foot wider, which leads to arch collapse and foot pain. But how do you know if you have splay foot? And if you do, what can you do to make sure the foot problem doesn’t become worse?

What are the signs of splay feet?

Most commonly, pain in splay feet occurs when they are overstrained, in particular whilst walking or standing, and disappears when in a resting position. The flattening of the forefoot and the foot’s falling arch often leads to bunions (hallux valgus), and at the same time the little toe starts to point inwards. This results in a malposition of the metatarso-phalangeal joints (claw foot, hammer toe,) and corns may form. Consequently, the second and the third metatarso-phalangeal bone have to carry a bigger load, and painful calluses occur on the sole of the foot. The patients concerned often have trouble finding appropriate shoes that offer enough space for their deformed feet.

What Causes It?

Many point to years of improper strain on the foot due to things like obesity or wearing unsupportive or uncomfortable shoes like high heels. Bone disease, paralysis, and a weakening of the ligaments and connective tissues in the foot (a common problem among aging women) can also cause the metatarsal bones to start spreading and breaking down.

As the metatarsal bones begin to spread further and further apart, the resulting foot pain often causes a change in walking style. People with splay foot often begin walking on the outside edge of their feet to avoid pain, rather than pushing off from the toes. This change in gait causes further weakening of the foot muscles as well as possible arch collapse both of which actually make splay foot more painful.

What examinations are made?

The patient is interviewed and undergoes a physical examination which usually makes it possible to establish a diagnosis, as each splay foot exhibits the same typical corn and callus pattern. This pattern is due to the malposition of the toes and the forefoot. On the X-ray the divergent angles between the metatarso-phalangeal bones can be measured, which helps to estimate the degree of deviation.

Treatment

One of the ways to decrease the pain caused by splay foot is to wear custom-fitted orthoses that help patients return to their normal gait. However, orthoses are widely considered a temporary solution because the feet eventually become dependent on the passive support provided by the orthosis and continue to weaken. The patient quickly becomes accustomed to the insoles and the pain returns over time leading the patient to walk abnormally again, which can lead to knee and back pain as well as calluses.

Podiatrists recommend their splay foot patients engage in foot strengthening exercises, as working the muscles in the feet can stop the metatarsal bones from further widening, create greater foot support and stability, and can help reduce splay foot pain.

There are several therapies to reduce the patients discomfort and to relieve the foot. The possible non-surgical therapies are:

• Foot manipulations/ stretches
• Relieving the pressure sores by wearing wide, comfortable shoes
• Immobilisation, when irritated
• Anti-inflammatory painkillers

Metatarso-phalangeal bones and toe deformities may be corrected surgically (Claw foot, hammer toe, bunions). There are a variety of surgical procedures suitable for the treatment of single toes, depending on the severity of the deformity and the discomfort experienced by the patient. The surgeon may treat bunions by realigning the joints through chevron osteotomy or by removing a wedge of bone (wedge osteotomy). The surgeon will study each case individually to decide what treatment is appropriate.

                              Your feet mirror your general health . . . cherish them!