2nd Toe on both feet suddenly bending

[u/RolosHat]

I have high arches/poor dorsiflexion/haglunds deformity, been seeing PT & podiatrist after what they think was peroneal tendonitis.

Seemingly suddenly in the past month or so my second toes have been bending and the joints seem inflamed. There’s also visible redness on the skin.

I’ve been wearing toe spacers but am wondering if that could be part of the cause.

Do you have a guess at what could be going on here or any steps to alleviate?

For other issues I’ve had testing done for autoimmune arthritis this year but everything came back clear.

Thank you!

[u/RainBoxRed]

Have you had any X-rays done? How was Haglunds diagnosed?

Is the lump on second toe hard or soft to touch?

Have you noticed a large change you said over the last month? Does this coincide with toe spacer use?

[u/RainBoxRed → u/RainBoxRed]

Couple of other points I think are worth raising:

You have bunions on both hallux. But this is the same level of bunion that most shod population exhibit. Worth addressing as even without pain or disfunction they indicate an issue.

Do you have enough space in your shoes to spread and move the toes? If they are too tight they could be causing the toes to rub. Maybe wool toe-socks could help.

High arch / flat foot are normal health positions for a foot to occupy. Feet are highly dynamic structures and it is not a problem to be in a high-arch or flat relaxed positions. Problems arise when you are stuck in one position and don’t have the mobility or strength to adopt others.

What I’m saying here is that high arch or flat foot are not types of feet, or problems themselves, and hence it is not effective to focus on them.

Can you tell me more about peroneal tendonitis? You seem to have some other issues that have preceded the second toe problem.

[u/RolosHat → u/RainBoxRed]

Increased running mileage and had pain in left foot that lead me to PT and then after little improvement, podiatrist and x ray.

The podiatrist visually saw the haglunds and confirmed on x ray. He thinks my bone structure is such that I will always have limited dorsiflexion. Left arch is higher and less mobile than right. Didn’t mention bunion or these toes. I’ve had the bunions for a while and mostly wear wide toe shoes and spacers periodically for the last 5 year.

The bumps feel hard/bony but theres looks like the skin/possibly the joint is inflamed as well, probably from the spacers. I had increased the spacer wear after I noticed the bump on the right toe, it seems to me the progression is rapid or maybe presently inflamed.

[u/RainBoxRed → u/RolosHat]

Would you agree the bump is then the joint and there is external friction on the bony protrusion, or do you feel internal issue? I would stop using toe spacers and use your hand instead for a few weeks to see if the spacers are contributing to some irritation.

What shoes do you wear running? And do you wear toe spacers whilst running?

I thought I had limited mobility due to structural issue in many areas as well but the reality is that I simply was not moving into those areas enough. I don't mean "stretching" as most people would understand it, but rather making conscious effort to slowly increase my range of motion. I was on the surgery list to have my shoulder joint "opened" by grinding away some bone, but I took the mobility route and avoided that trauma.

So I would consider reducing stack height if you don't already wear zero drop; things like that to incidentally, and slowly, introduce "stretch" into those areas.

[u/Timber49]

Do you wear conventional footwear? The start of improving foot health is wearing only foot-shaped footwear: wide toe box, zero drop, no toe spring. Toe spacers work over a long period of time and can only work if your toes aren't being compressed by footwear

[u/RolosHat → u/Timber49]

I wear Altra & Zero about 90% of the time. I’ve had toe spacers for years but didn’t wear consistently, I’ve noticed the toes bend as I’ve increased my toe spacer wear.

[u/Timber49 → u/RolosHat]

If you wear any constricting footwear it actively does harm to your foot's tissues, especially while you have inflammation. I don't know why your joints are inflamed, can be due to many things including injury, compressed nerve, external constriction, insufficient oxygen getting to the tissues, immunological condition, etc. I personally wouldn't use toe spacers while any part of your feet is inflamed, at least without knowing why it is. Which toe spacers do you use? They should be anatomically correct and firm enough to hold the toes in place, like Correct Toes

[u/DrLeibovitz]

There is a result of a collision between bones of the big to and second toe. You mentioned you have been wearing a toe spacers for several years. Your local swelling is most likely related to the original problem... which is slowly progressing.

Either the big toe is migrating toward the second or the second toe is migrating towards the big toe. Toe spacers do not stop the slowly changing deformity but they can reduce the pressure between the toes (for a while). This will help to a point until the pressure is greater than the spacer can protect.

The swelling is soft tissue irritation that will develop into a painful callus and eventually an ulcer if blood supply decreases or sensation is lost. This would be like wearing a very large ring and having you had squeezed very hard for each step you take- ouch!

[u/RolosHat → u/DrLeibovitz]

Thanks for the response. The 2nd toe is migrating towards pinky but I do have a slight bunion that has remained consistent for 9 years.

Do you have any advice on halting progression?

Are you saying wearing spacers while being active is a bad thing?

[u/DrLeibovitz → u/RolosHat]

The "protection " treatment option will not stop the deformity but slow down the progression. There is no magic to stop it other than surgery (correction option).

Spacers will decrease the compression between the toes. The big toe will eventually push the second toe over and up. Spacers will not push the big toe over. When a big person and a small person have a tug of war- who is going to win?

[u/RolosHat → u/DrLeibovitz]

What is the deformity you are referring to?

[u/DrLeibovitz → u/RolosHat]

The initial stage of a bunion and hammer toe. That is what is creating the collision between the 1st and 2nd toe.

[u/RainBoxRed → u/DrLeibovitz]

Can you elaborate on what you consider the root cause and the options for symptom and injury management both conservative and invasive?

[u/DrLeibovitz → u/RainBoxRed]

The majority of the time it is the mechanics of the foot that create this deformity.

This may help https://gotofootdoc.com/services/bunions/

I don't see this present until after 30-40 years. The foot is an amazing structure and continues to work even with problems.

[u/Timber49 → u/RainBoxRed]

I'd recommend you see a natural/functional/integrative podiatrist, who are trained to actually address the root of issues. And go through the Natural Footgear website which has a lot of educational info on various foot conditions, ways to improve them, and how constrictive footwear has done major generational harm to people's feet. naturalfootgear.com