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Hi everyone I'm fairly new to this so bear with me if I don't add all relevent details. I basically have a 14-year-old girl who leads a sedentry lfestyle, where's ballet pump shoes and UGG boots therefore no support whatsoever! She complains of toes 2-5retracting at DIPJ therefore forming mallet toes BF which are reduceable somewhat passively. She has a high arched foot type, with slight forefoot equinus, she has soft tissue equinus at both ankles approx 90+ 5degrees. All I can think of for treatment is digital props, I was trying to also convice myself that if she has a soft tissue ankle equinus this may help as it may cause extensor substitution and pull the digits back - however now I think this will make matters worse as it will claw the toes more??

Any help or thoughts would be most welcome - I've banned her form unsupportive shoes !!

cheers Bartypb

 

Hi,

An arch accommodating EVA orthotic device with a 1st met head cutout and substantial metatarsal dome/bar may help.

Cheers,

Brad:drinks

 

I presume you have put her 5 x day gastroc/soleus stretching regime?

 

sounds like the unsupportive shoes are allowing the excessive pronation and some form of flexor stablisation to maintain ground contact which could lead to the lesser toe deformity.

definately some for of gastroc/hamstring stretch, with footwear advise.

is the deformity still flexable?

 

Is the foot type progressing or hereditary? All neuro tests ok? Don't forget about all the nasties that can be associated with retracted digits, clawing and highly arched feet.

 

Hi,

any neuro history? Regarding the ankle equinus an issue may further be the amount of forefoot weight bearing. Depending on the nature and origin of the equinus you may have some concerns regarding stability.

Regards
NIKO