Splayfoot: Causes, Symptoms & Treatment

Splayfoot, or pes transversoplanus, is an avoidable splay of the forefoot that is often caused by obesity and improper footwear.

What is splayfoot?

A splayfoot is a visible and measurable deformation of the entire forefoot. It is caused by the lowering of the front arch in the foot. As a result of the subsidence, the toe bones visibly spread apart. Chronic overloading of the toe joints on the little and big toe and characteristic callus formation occurs. As a result of further stress, splayfoot develops into a painful foot, followed by typical deformities and overuse symptoms of the toes.

Causes

Causes leading to the development of splayfoot include obesity, unsuitable footwear without adequate arch support, a penchant for high heels or hereditary connective tissue weaknesses. Certain bone fractures in the forefoot can also promote splayfoot. The so-called “marching fracture” should be mentioned here in particular. This is a fatigue fracture of the metatarsal bones. It can be caused by overloading or unaccustomed stress such as long walks. Women are diagnosed with splayfoot about four times more often than men. The reason is that women more often wear unsuitable footwear with high heels. As a result, the forefoot is stressed beyond normal levels. Narrow shoes – just like shoes that are cut too wide – cannot prevent splayfoot in the long term if there is no unsupport of the arch of the foot. Often the splayfoot remains symptom-free in the first years. As a result of the spreading of the forefoot, however, altered gait habits and consequent renewed incorrect weight-bearing can occur. The increasing spreading process can lead to malpositions of the toes or joint diseases of the foot. The famous hallux valgus, the so-called hammer toe, arthritis of the toe joints, corns or Morton’s neuroma are attributed to the splay foot.

Symptoms, complaints and signs

Splayfoot is first recognized by the characteristic deformity of one or both feet. Typically, the forefoot is widened and lowered, while the big toes shift outward. The pain occurs mainly when walking and standing. There is no discomfort at rest, insofar as no secondary complaints have yet developed. However, the altered position of the foot can lead to the development of claw toes or hammer toes. In the course of time, splayfoot can lead to pain and calluses on the sole of the foot. Normal walking is usually no longer possible, which can result in avoidance behavior and further malpositions in those affected. Splayfoot can be recognized by the unusual rolling motion of the sole, in which the affected person rolls the foot over the outer foot. Accordingly, swelling and callus formation occur primarily on the outside of the foot. If splayfoot is operated on at an early stage, the symptoms can be completely eliminated. If treated too late, permanent damage to the foot may already have occurred. Possible secondary symptoms are joint wear, bone damage, skin changes or walking disorders. Particularly in the case of a congenital splayfoot, an abnormal gait can develop during childhood, which impairs posture.

Complications

Splayfoot can lead to overstretching of muscles and ligaments. This can result in chronic abnormal stress on the affected bones and joints. Thick, painful calluses often form under the skin of the sole. A typical complication is also the so-called Morton’s neuralgia, a permanent irritation of the nerves that leads to nerve nodules in the long term. These nodule-like thickenings cause severe pain and are often also associated with restricted movement and sensory disturbances. Splayfoot also promotes the formation of toe deformities such as hallus valgus, mallet toe or claw toe. Once developed, further deformities can lead to far-reaching complications and chronic movement restrictions, which may also result in psychological suffering such as depressive moods or inferiority complexes. There are also risks associated with treatment. Poorly adjusted aids can possibly exacerbate the splayfoot and cause further pain.A surgical procedure carries the usual risks: Bleeding, secondary bleeding, nerve injury, scarring and inflammation. Prescribed medications can bring side effects and cause allergies. The most common side effects are gastrointestinal discomfort, edema, and blood clotting disorders. Rarely, gastric ulcers and kidney disease can occur. Intolerance to prescribed painkillers and anti-inflammatories also cannot be ruled out.

When should you see a doctor?

If splayfoot occurs, it is usually always necessary to see a doctor. If the splayfoot is not treated properly or not treated in time, it can lead to serious and, above all, irreversible damage to the feet that can no longer be treated. The underlying condition should also be treated. A doctor should be consulted if there are clear deformities on the feet. These can be seen with the naked eye and can occur either on one foot or on both feet. Furthermore, malformations on the toes can also indicate a splayfoot and should also be treated by a doctor. Most patients also show increased formation of calluses or very severe swelling on the feet. Walking difficulties can also indicate splayfoot. If these complaints occur permanently and do not disappear on their own, a doctor should be consulted in any case. Splayfoot can be treated by a general practitioner or by an orthopedist. As a rule, the treatment of the underlying disease is in the foreground, so that no general prognosis can be given about the further course of the disease.

Treatment and prevention

There is no surgical treatment for splayfoot. But some of the secondary conditions – such as hallux valgus – can be surgically straightened. To treat the main problem, the splayfoot must be supported early. But the controversial question is with what kind of health shoe, pad or insole this is done. According to orthopedists, some so-called health shoes promote the development of splayfoot due to their excessive width in the forefoot area. Even with a footbed, the forefoot can be pushed too far apart in such shoes – for example, if you are overweight or have a standing job. For children, walking barefoot can help strengthen the arch of the foot. Adults with splayfoot are initially advised to reduce their weight, wear orthopedic insoles, walk barefoot and do foot exercises. If there are already inflammatory processes in the toe area, immobilization of the foot is helpful. Changing the footwear is useful in case of splayfoot. Callus formation can be treated with warm foot baths and callus shaving. However, it makes more sense to stop callus formation in splayfoot by wearing suitable footwear. Flat footwear with enough space for the toes is advisable for splayfoot.

Aftercare

In most cases, the person affected by splayfoot has only a few and also very limited measures of direct aftercare available. Therefore, in the first place, the affected person should see a doctor early on in this condition and initiate treatment to prevent the further occurrence of symptoms or complications. It is not possible for the disease to heal on its own, so treatment by a doctor is always necessary. In general, a healthy lifestyle also has a very positive effect on the further course of this disease. Excess weight should also be avoided as far as possible, and the person affected should also engage in sporting activities to counteract the symptoms. In many cases, suitable footwear can also alleviate and limit the symptoms. Therefore, special footwear should be made and worn. Likewise, regular checks and examinations by a doctor are very important. As a rule, the complaints can be well limited, so that it also does not come to a reduced life expectancy of the affected person. However, the feet should be particularly well controlled by the doctor, in order to recognize arising complaints and damages in time.

What you can do yourself

In everyday life, special attention should be paid to the choice of footwear. This should neither be too tight nor have high heels. The size of the shoes should match those of the feet. Before purchasing new shoes, they should always be tried on.In addition, it is advisable to check the materials used for the manufacture of the shoes. Wearing plastic shoes has proven to be unfavorable. Very flat shoes with a thin sole can also cause disturbances in everyday life and should also be avoided. As soon as the affected person notices discomfort while wearing the shoes, he should take them off and change to other footwear. Closed shoes are important for optimal locomotion, as well as wearing hosiery made of cotton. In addition, to reduce discomfort, care should be taken to avoid the development of excess weight. A healthy food intake rich in vitamins and checking the calories consumed during the day will help to maintain a normal weight. Sweets and the consumption of sugary products should be checked daily. Sufficient exercise and the performance of sports activities are also important to avoid obesity. As soon as signs of fatigue appear or discomfort becomes apparent, periods of rest should be taken. The feet are to be rested and should be spared.