Best Foot Deformity Articles & Progressives Deformities to Know

Progressive foot deformities can develop slowly. You may notice one of your toes gradually becomes crooked, one of your shoes doesn’t feel like it fits in usual areas or you fatigue while walking sooner than you used to. Each of these can be signs of early deformity. Over time these deformities can develop, causing further changes to your walking mechanics, pain, and limitation in activities. Catching them early allows conservative treatment to slow the deformity down while maintaining normal function.

What is a progressive foot deformity?

A progressive foot deformity continues to get worse with time rather than resolving spontaneously. They occur due to a combination of weak, torn, or loose supportive structures in the foot. Additionally if there is altered sensation in the feet ( neuropathy ) deformities can occur.

Early changes typically cause flexible deformities, which means they improve when you’re not standing on the affected foot. Without treatment, deformities can progress until they become fixed or rigid.

Your doctor will try to determine if the deformity is caused by a problem in one joint or if it is compensating for another deformity up or down the foot. Do you notice your pain is worsening or changing as your deformity is progressing? Do you have areas of decreased sensation in your feet? Are you developing new calluses or break in the skin over bony areas of your feet? Is footwear becoming difficult or painful? All deformities that are causing pain, fixed or worsening should be evaluated by a foot specialist.

Examples of Progressive Foot Deformities

Although there are several progressive foot deformities, the most common progressive deformities include bunions, hammertoes, Adult acquired flatfoot, high arch (cavus foot), and Charcot Arthropathy.

Bunions (Hallux Valgus)

Have you noticed your big toe drifting towards your other toes and developing a painful bump on the inside of your foot? If so, you may have developed a bunion. Bunions usually begin in a flexible position, but can become fixed over time. Symptoms may start with shoe irritation and forefoot pain. As your body weight shifts off of your big toe joint you may experience additional deformities and hammertoes due to crowding of your toes.

Hammertoes

The smaller toes in your foot can develop deformities as well! Hammertoes are when your toes begin to bend down at your middle joint and become rigid over time. Symptoms typically begin as a flexible postural deformity. Pain can occur at the top of your toe joint or on the tip of your toe as a result of excessive pressure when shoes rub against your toes.

Adult Acquired Flatfoot Deformity

Have you noticed the arch in your foot is beginning to fall and your foot feel wider when you look at it? If you’re experiencing these symptoms you may be developing flatfoot. Adult acquired flatfoot usually occurs due to a tendon injury in your foot called posterior tibial tendon dysfunction or PTTD. Patients will commonly develop pain on the inside of their ankle, loss of push off strength when walking and be unable to stand on one foot.

High arch ( cavus foot )

High arch deformities are less common, however they are equally as important to understand. This deformity causes you to have increased pressure across your heel and forefoot when weightbearing. Neurologic conditions are often at play with this deformity. If you have frequent ankle sprains, clawing of your toes and pain on the outside of your foot you may have a high arch foot deformity.

Charcot Arthropathy

Charcot arthropathy is a severe deformity that commonly affects people with neuropathy (loss of feeling in feet). This condition can progress rapidly and cause warmth, swelling and deformity of your midfoot with minimal pain. Early recognition and treatment is essential to help prevent severe deformity and ulceration from developing.

What causes progressive foot deformities?

Many factors play a role in the development of foot deformities. Some deformities you are at greater risk of developing due to genetics and your foot type. Certain shoes, repetitive use injuries, previous injuries to your feet and ankles, and age can all cause deformities to progress.

Medical conditions such as diabetes, inflammatory arthritis, and neuropathic diseases can weaken the supporting structures of your feet and ankles.

Obesity and jobs that required prolonged standing can place extra stress on your feet. Catching these issues early can help you prevent future deformities.

Symptoms of progressive foot deformities

Some common symptoms that your foot deformity is progressing include: increasing pain with activity, noticeable changes in toe position, arch height of your foot, shoes feeling too tight, recurring calluses over bony areas of your feet, and difficulty standing or walking long distances. Have you noticed it is harder to do a single leg heel rise? Does your foot seem unstable when you walk? Often these are indications that your foot strength and alignment is getting worse.

If you have lost feeling in your feet due to diabetes or another illness it is important to check your feet daily for swelling and areas of warmth. These may be signs of a Charcot foot deformity and should be evaluated early.

Diagnosis of progressive foot deformities

Doctors diagnosis progressive deformities by performing a physical exam on you and taking weight bearing X-rays to determine the degree of deformity while you’re standing. They will measure certain angles on your feet, observe you walk, and check to see if your deformity is flexible or fixed. Other advanced imaging such as MRI’s or Ultrasounds can be obtained to assess the integrity of your tendons and joints if they suspect something other than a deformity is causing your pain.

Many patients with progressive deformities visit Treasure Valley Foot & Ankle because their foot or ankle pain is beginning to affect their daily life or they have noticed their foot shape changing. Seeing your doctor early allows you to understand what deformities can be managed without surgery and which need to be closely monitored for changes.

Slowing the progression of deformities

Early is key when trying to slow progression of a foot deformity. Wear shoes that fit well and provide support. Shoes with a wide toe box, low heel and supportive sole can help decrease pressure off of your bony prominences. Custom made orthotics or even store bought orthotics may help redistribute your weight across your feet and support the joints in correct alignment.

There are also specific exercises you can perform to help strengthen your feet and increase ankle flexibility.

If your deformity continues to get worse despite these measures or you begin to develop recurrent areas of irritated skin (rubbing against shoes) it may be time to consult with a surgeon. The sooner you seek treatment, the more options you have and typically the better off you will be long term.

Frequently Asked Questions

Q1: What are the first signs of a progressive foot deformity?

Some signs that you may have an early progressive foot deformity include: one of your toes slowly becomes crooked, you notice your shoe feels too tight in certain areas it used to, or you fatigue while walking.

Q2: Can foot deformities progress if I don’t have pain?

Yes! Some deformities can structurally progress before they cause you pain. This is common in those with neuropathy or inflammatory arthritis.

Q3: When should I seek treatment for a foot deformity?

If you're noticing your feet look different, your foot pain is worsening, shoes are feeling too tight, or you develop recurrent areas of irritated skin on your feet, please seek treatment with your local foot specialist.

Q4: Will orthotics really help slow the progression of my deformity?

Orthotics can help! When used early in the disease process and worn consistently, they can decrease the stress placed on vulnerable areas of your feet.

Q5: Do I need surgery for all progressive deformities?

Absolutely not! Most progressive deformities can be treated non-surgically, especially if caught early.