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How to Treat Overlapping Toes

by Jaydee Vykoukal, PT, DPT July 27, 2021 0 Comments

wearing toe spacers

If you are dealing with overlapping toes (or underlapping toes), you may be wondering what is the best first step in getting treatment. There are two primary concerns when it comes to one toe overlapping an adjacent toe: correcting the misalignment and addressing any pain or current tissue breakdown. There are a variety of options that are often used in conjunction to get the best results and keep you living life free of toe and foot pain. Keep reading to learn how to treat overlapping toes.

How to Straighten Overlapping Toes

Once your toes are overlapping, the best thing you can do is to promptly seek treatment. This will prevent the issue from getting worse and harder to manage down the road. The sooner you get help and attempt to restore toe alignment the better. Most often, the first line of defense is use of simple tools that can hold the toe(s) in a better position. If that doesn’t work, surgery is always a last resort option too.

Toe Separators and Spacers

One simple solution for correcting crooked toes are toe straighteners, such as toe separators or toe spacers. Toe separators are generally designed to address every web space of the foot at once while toe spacers can be used to target two or more specific toes. They are designed to help realign the toe with consistent use. Additionally, they can provide toe pain relief and be worn discreetly in shoes.

These are a great low cost option that you can buy on your own. You can also talk to your podiatrist about custom fit options if the ones you find online don’t seem to fit your foot correctly. 

Toe Splints

There are a variety of toe splints on the market depending on which toes are your problem area and which specific condition you are dealing with. Options include a bunion splint, universal toe splint(can be used on any affected toe), and a hammer toe splint. Plus, there are other options that may address mallet toes or claw toes as well. Splints are generally comfortable enough to be worn all day long to promote gentle realignment of the necessary toes. Otherwise, you might opt to wear one at night when sleeping. Again, you can talk to your podiatrist about which option would benefit you the most. 

Surgery

Occasionally, surgery is indicated for an overlapping toe. Conservative treatment options should always be considered first to minimize the required invasiveness. If pain is severe or the toe is not responding to realignment techniques effectively, usually due to excessive stiffness, surgery can be used to place the toe in a better position for the long term. Once surgery is completed, you can expect to receive physical therapy treatment and get fitted for optimal shoes to make sure that your toes don't return to their misaligned position over time due to faulty movement patterns, shoe wear, and posturing. 

How to Manage Pain from Overlapping Toes

The biggest reason people seek treatment for overlapping toes is due to pain. Whether your big toe or second toe is affected, your daily mechanics can become compromised and exacerbate pain. In general, a mix of treatment options will yield the best results with one or more of the following:

Proper Fitting Footwear

One of the biggest factors in treating overlapping toes is managing the onset or progression with your choice of properly fitting shoes. When there isn’t adequate space in the toe box of the shoe or there isn’t enough flexibility to allow the toes to properly flex, this can lead to some major issues like pain in the toes and foot. When choosing footwear, always choose a style that provides adequate space for your toes without them feeling squished or being rubbed. Most often the toe box will need to be extra spacious to allow room for your overlapping toes until they can be realigned. This means high heels, flats, and other options that tend to have a tight toe box and squish the fifth toe are out.

Not sure where to start? Many local shoe stores can provide you specific recommendations and fittings. Otherwise, talk to your podiatrist about what brands they recommend for your feet.

Foot & Toe Alignment

Orthotic padding or full orthotic insoles can help reduce pain on sensitive areas and help restore better alignment and mechanics to your foot. Orthotics can be especially helpful if you are also dealing with flat feet. It’s always important to talk to your doctor about which option is best for you, especially if you’re dealing with issues like Diabetes, to avoid accidentally exacerbating your pain.

Find the Right Orthotics for Your Feet

Bandages & Corn Protectors

The skin that is being rubbed between overlapping toes can develop calluses or blisters and get swollen, sore, and irritated- which is the primary source of pain with this condition. Simply applying a protective layer to reduce friction can give quick relief to your skin. Corn protectors or toe sleeves can provide coverage and protection to the entire affected toe to promote healing and reduce continual rubbing. Additionally, you can grab a Band-Aid from your first aid kit or custom cut some moleskin to cover any red and sensitive areas. Make sure to check your skin health regularly and allow your skin some breathing time between wear as well.

Cold Therapy

Cold therapy is a great short term option for addressing both pain and swelling. For the best results, apply ice for 15 to 20 minutes at a time. Do not exceed 20 minutes to avoid damaging your skin. You can use ice every couple of hours throughout the day as needed for pain relief, hopefully reducing your need for pain medication.

Exercises & Physical Therapy

A well designed exercise program for your foot, ankle, and toes can help promote better toe alignment as well. This will generally include a mix of gentle stretches, strengthening, and coordination exercises to maximize your ability to participate in daily activities. Often, faulty movement mechanics may need to be addressed as well, since they can initiate or exacerbate your poor toe alignment. The best way to get started is to work with a physical therapist that can give you personalized exercise recommendations (in addition to other treatments) to maximize your outcomes. Here is a short list of exercises to get started with below.

Stretches

Promoting good overall flexibility in the foot, ankle, and toes can help reduce the strain that is being put on your sore toe(s). Try these gentle stretches to help realign the affected joints:

  • Calf Stretches
  • Toe Curls
  • Ankle Pumps

Strength and Coordination

Muscle imbalances within the foot, or anywhere in the lower leg, can also initiate or exacerbate your overlapping toe symptoms. Restoring balanced strength and proper coordination while boosting blood flow for healing can also be a game changer for relieving pain and reducing the risk of future problems. 

Toe Scrunches
Single leg stance

Maintaining a Healthy Weight

Being overweight or obese is also hard on the entire body, particularly when it comes to foot problems. The additional weight puts massive strain on the joints and can lead to excessive wear of cartilage and other general imbalances. Keeping a healthy weight is an important factor in managing any type of health related issue, especially the toes where all the weight has to be distributed with each step we take. Losing weight or maintaining a healthy weight is about more than just exercising or going on a diet. Here are some tips to keep in mind for staying in a weight range that your body can adequately cope with:

  • Focus on eating more whole foods and less processed food
  • Take frequent breaks from sitting to move your body- at least 5 minutes every hour
  • Exercise at least 3 times per week
  • Drink enough water
  • Practice stress management regularly 
  • Get enough sleep
  • Manage any pain that comes up quickly
  • Take care of your mental health
  • Socialize regularly with friends and family
  • Reduce your toxin exposure in your diet, cleaning supplies, water supply, etc.  

Straighten Toes & Relieve Pain

If you choose to ignore your overlapping toes, there is a high chance you will have to deal with the consequences at some point as symptoms become moderate to severe. Addressing your toe alignment with proper foot care as soon as you notice a change you will be at much lower risk of encountering any long term consequences. 

If you are feeling unsure of where to start, always seek professional help from an orthopedic doctor, podiatrist or physical therapist. If your symptoms suddenly get worse or they are having a negative impact on your quality of life and mental health, seek help immediately for medical advice.

Sources:

https://www.thefootandankleclinic.com.au/condition/overlapping-underlapping-toes/

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.



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