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This new Ask An Expert yoga article is provided by Dr. Carla Cupido.
Q: I have a different sort of question for which I hope you can offer some suggestions or links to resources that will help. Recently, I have been diagnosed with developing hammer toe. My problem is a swelling and discomfort in the ball of my foot anytime that I do any yoga poses that put weight on that foot. My first action, of course, was to drop out of my yoga class. However, I feel that yoga, if doing the correct exercises might help. Are you aware of any others that have experience this problem and have had success with continuing yoga practices?

A: There are a number of different conditions similar to hammer toe, such as claw toe, curly toe and mallet toe. A hammer toe is defined by an extended metatarsophalangeal joint (proximal joint of the toe), a flexed proximal interphalangeal joint (middle joint of the toe), and a hyper-extended distal interphalangeal joint (distal joint of the toe). Yes, this is a whole lot of Latin to basically say that the toe is curled, causing the middle part of the toe to stick upwards in a way that it rubs perfectly against the top of your shoe and causes significant discomfort and fantastic bunions. The balance of the translation is that the ball of your foot in line with the affected toe hurts a lot!

There are a number of different causes of hammer toe. Diabetes, stroke, osteoarthritis, rheumatoid arthritis, and other underlying pathological conditions can play into the development of hammer toe. Therefore, it is always important to seek the advice of a medical practitioner if you are noticing changes in the condition of your toes so that they can rule out such underlying conditions. Shoes that are too small or are fabulously pointy are also major contributing factors to this condition. If your toes are unable to lie flat in your shoes, you are placing your little toes at risk. Of course, this develops over a long time, so be mindful of your shoe selection and give your toes a break on occasion. Previous toe trauma can also be a factor in developing hammer toe.

Maintaining flexibility in hammer toes is very important as without flexibility, they may continue to become quite rigid and in time affect your gait. Conservative care options for this condition are not well represented in the literature and it has not yet been studied with yoga rehabilitation. However, using yoga to help manage this condition could be great. I have not come across the use of yoga for hammer toe yet; however, if approached delicately and wisely, it may be of help.

You should most definitely make an appointment with a health care practitioner who can assess your gait, muscular weaknesses, muscular and tendonous restrictions, and conservatively treat your toe before moving forward with yoga. However, once you have been given the go-ahead, poses that help to stretch out the toes could be of great benefit to you. If it is not painful, trying to go up your toes in downward dog which could help to lengthen through the musculature and tendons through the bottom of your foot and toes.

While in poses in which your hands are in contact with your toes, gently attempt to straighten your toe and even take a few more minutes in that pose to massage the bottom of it. Your goal is simply to keep that toe mobile. As for the ball of your foot, try to modify poses to take the weight off of this area until it is feeling less painful. Part of the reason the bottom of the foot hurts is because of the angle that the toe is taking relative to the ball of the foot. Therefore, if you can loosen off the tissues on the bottom of the foot and into the toe, this may take some of the pressure off the ball of the foot. Make sure this is assessed though as if it is severe, your joint may in fact be subluxated.

A lot of this will be trial and error for you. If it feels good, go for it and if it doesn’t, either stop or go get it checked out. I strongly encourage you to seek out a medical practitioner who can help you through this experiment. Best of luck and be gentle with your body.

For additional information on hammer toe and other foot pathologies, click here.

Dr. Carla Cupido
Hon.B.Kin., D.C.
A.R.T., Graston

www.drcarlacupido.com
For more info about Dr. Cupido and to read more of her articles, click here.

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