Wednesday, January 9, 2013

Hitchhiker's Toe

"Hit the road, Jack, and don't you come back no more no more..."
Hitchhikers are often seen on major state roads, giving the old thumbs up gesture, an indication that they're looking for a ride. But did you ever see a hitchhiker giving the old big toe up gesture???
Hitchhiker's toe resembles the thumb of a hitchhiker, due to the hyperextension of the extensor hallucis longus muscle. This involuntary position is also called striated toe.
A patient often develops the hyperextension of hitchhiker's toe from spasticity,  which is caused by brain injuries, like a stroke, neurological condition, or spinal cord injury. Some toes are painful because of an altered gait or shoe fitting issues. This issue is also commonly found with other neurological conditions; drop foot and equino varus deformity are also common with hitchhiker's toe.
Symptoms include the first toe pulling up instead of lying down as it should, pain due to pulling on the muscle, and pain or callusing on the toe where it hits the shoe. The patient should look out for when the foot moves into the varus position, the aftereffects of a stroke or other neurological condition, or recovery from spine surgery or injury.
Causes of this deformity include stroke, cerebral palsy, physical trauma, such as a spinal cord injury, and
other neurological disorders.
The goal of treatment is to restore balance and support in the foot, since the big toe bears a great deal of our body's weight. An lower and thinner orthotic may be created to support the longitudinal and metatarsal, and bracing may be necessary to relax the toe. The patient should avoid flip-flops, except those approved by the American Podiatric Medical Association, high heels, and going barefoot. Physical therapy may be prescribed to regain strength in the toe.
If you have hitchhiker's toe, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
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