Diagnosis

The diagnosis of splayfoot can be made from the symptoms and the physical examination. Due to the described malpositions, a pathological pattern of callosity occurs over the 2nd and 3rd metatarsal bones.The examination findings include:

Examination in standing position: A widening of the forefoot is observed and the transversal arch sinks.
Examination in a sitting position: Characteristic calluses and corns can be seen on the sole.
An X-ray image can provide further information. In this case, a changed angle between the 1st and 2nd metatarsal bones can be seen, as well as the fanning out of the metatarsus (splayfoot).

A permanent erection of a sunken transverse arch can usually not be achieved with conservative or surgical measures.

To treat the foot malposition, conservative measures are taken, while accompanying toe deformities are corrected surgically. The different therapy concepts are: You may receive an insole?

Avoid shoes that are too tight and too high
Immobilization, alternating baths, medications for anti-inflammation and pain relief
Relief of pressure points via a retrocapital splayfoot orthosis

Specific exercises can actively strengthen the foot muscles.

The focus of splayfoot gymnastics is on building up the longitudinal and transverse arches. It is recommended to train barefoot! Of course, each exercise should only be practiced as long and intensively as the general condition and state of health allow.

Several times a day, stand on your toes and slowly rotate your feet. The heels must not touch the ground. At the beginning you can start with 10 repetitions on both sides, but in the course of the training it is desirable to increase this to at least 20 repetitions.

It is not uncommon for your feet to ‘crack’ the first few times! This exercise is ideal to integrate it into your everyday life in a time-saving way: For example, you can strengthen the foot muscles at the same time as you are telephoning or brushing your teeth! For this exercise you need a thin stick, e.g. a pencil.

Now stand carefully on the stick and let it roll slowly from the heel to the toes. Each side is repeated several times. For this exercise you use a stick again.

Claw the toes of one foot into the ground so that the sole of the foot hovers above the ground, forming a kind of bridge between the heel and the toes. Now you do not touch the stick with the sole of your foot anymore and slide forwards and backwards with small movements, still without touching the stick. Repeat several times on both sides!

Now try to grip the stick with the help of your toes. If the mere lifting of the pole works well, you can try to hold the pole longer and put it down in a box, for example. This exercise is well suited for children with splayfeet, as it can easily be made playful: Instead of the stick, you can choose colorful marbles of different sizes, which can be placed in different colored pots, etc.

For this exercise you need a small ball. You stand on the ball and actively push it backwards using your foot muscles. It is recommended to start at the front of the toes and continue backwards.

Make sure to perform the movements slowly and in a controlled manner! The following exercise must be done in a sitting position. To do this, lift your legs and clamp the small ball between the balls of your feet.

Now carefully transport it towards your heel without the ball falling off. It is possible that the calf muscles may be stressed during this exercise. To prevent muscle cramps, you should shake out the calves loosely after each repetition.

During this exercise, a thin towel or a small scarf is spread out on the floor. Now grab an edge with your toes and pull it towards your foot with small claw movements. To increase the intensity, a thicker towel, e.g. terry cloth, can be used during the exercise.

Now try to grab the towel with your toes and lift it up. Would you like to learn more about exercises and physiotherapy?

Several times a day, stand on your toes and slowly circle your feet.
The heels must not touch the ground. At the beginning you can start with 10 repetitions on both sides, but in the course of the training it is desirable to increase this to at least 20 repetitions. It is not uncommon for your feet to ‘crack’ the first few times!

This exercise is ideal to integrate it into your everyday life in a time-saving way: For example, you can strengthen the foot muscles at the same time as you are telephoning or brushing your teeth!
For this exercise you need a thin stick, e.g. a pencil. Now stand carefully on the stick and let it roll slowly from the heel to the toes. Each side is repeated several times.
In this exercise you use a staff again.Claw the toes of one foot into the ground so that the sole of the foot floats above the ground, forming a kind of bridge between the heel and the toes.
Now do not touch the stick with the sole of your foot anymore and slide forwards and backwards with small movements, still without touching the stick. Repeat several times on both sides!
Now try to grip the stick with the help of the toes. If the mere lifting of the stick works well, you can try to hold the stick longer and put it down in a box, for example.
This exercise is well suited for children with splayfeet, as it can easily be made playful: Instead of the stick, you can choose colorful marbles of different sizes, which can be placed in different colored pots, etc.
For this exercise you need a small ball. You stand on the ball and actively push it backwards using your foot muscles. It is advisable to start at the front of your toes and continue backwards.
Make sure to perform the movements slowly and in a controlled manner!
The following exercise must be done in a sitting position. To do this, lift your legs and clamp the small ball between the balls of your feet. Now carefully transport it towards your heel without the ball falling off.
It is possible that the calf muscles may be stressed during this exercise. To prevent muscle cramps, you should shake out the calves loosely after each repetition.
In this exercise, a thin towel or a small scarf is spread out on the floor. Now grab an edge with your toes and pull it towards your foot with small claw movements.
To increase the intensity, a thicker towel, e.g. terry cloth, can be used during the exercise.
Now try to grab the towel with your toes and lift it up.

An operation to correct splayfeet should be arranged very cautiously! The operation is problematic in so far as the foot represents a functioning unit. All parts interact with each other and every small bone has its exact place.

If the position of the metatarsal or toe bones is corrected individually, the entire statics and mechanics of the foot can change. In particularly stubborn and painful cases of splayfoot, surgery nevertheless offers the possibility of improvement. However, only if the conventional treatments (physiotherapy, splayfoot orthosis) have already been patiently applied over a long period of time without success.

As a rule, this applies to stiffened (contractile) splayfeet, which are characterized by severe changes in the joints. There are various surgical options, mostly parts of the metatarsal bones are selectively cut through. This procedure is also called osteotomy.

Often parts of the metatarsal bones are removed with the aim of lifting the painful heads. However, the procedure is delicate: If the lifting is done too much, a very painful overload occurs! In technical jargon, the resulting pain is also called ‘transfer pain’.

Furthermore, a so-called subcapital (below the head) osteotomy can be performed. Here the bone below the metatarsal head is cut through and fixed with small screws or wires so that the heads are moved backwards. In particularly severe cases, when the patient can hardly walk and the pain is unbearable, the last option is a complete removal (resection) of all metatarsal heads.

To do this, all the heads are shortened at the same height so that an even line is created. In many cases, the pain is reduced after the operation and patients can walk again without pain. Malpositioning of the toes (deformities) is very common in splayfeet, e.g. hammer toes or hallux vagus (deviation of the big toe to the side).

Therefore, this part of the foot malpositioning should also be considered when choosing the surgical method. Insoles can help to treat the splayfoot and relieve the pain. Insoles compensate for the shifted balance of forces in the arch of the foot.

They serve to recreate the original anatomical position and thus restore a natural weight distribution. However, insoles should always be fitted professionally and should not be purchased as a lump sum over the Internet. An insole must be 100% adapted to the foot, otherwise the problem will be aggravated and even greater pain and damage may result.

Suitable insoles can be found in specialized shoe stores or stores for orthopedic needs.There you can also have an adjustment and consultation. Orthopedic insoles, as used for splayfeet, are somewhat more expensive than conventional insoles. They are in the range 30 – 150€ per pair.

However, several pairs should be purchased for hygienic reasons. The insoles can take away pain and stop further deterioration, especially in the early stages. In very advanced stages, however, insoles alone are usually not enough, and surgical therapy is usually necessary in these stages.

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