From the Research
Treatment for toe hyperextension should prioritize conservative measures, including rest, ice, and anti-inflammatory medications, as well as physical therapy and custom orthotic inserts, before considering surgical intervention, as supported by the most recent and highest quality study available 1.
Key Considerations
- Conservative treatment is the initial approach for managing toe hyperextension, focusing on reducing pain and inflammation, and promoting proper healing and alignment.
- Physical therapy plays a crucial role in strengthening the intrinsic foot muscles and flexor tendons, which is essential for long-term resolution and prevention of further injury.
- Custom orthotic inserts with metatarsal pads can help redistribute pressure and provide proper support, reducing the risk of exacerbating the condition.
- Proper footwear is essential, with adequate toe box space and good arch support, to avoid worsening the condition.
Treatment Options
- Rest, ice, and anti-inflammatory medications like ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily) for pain and swelling.
- Physical therapy focusing on toe and foot strengthening exercises, particularly targeting the intrinsic foot muscles and flexor tendons.
- Custom orthotic inserts with metatarsal pads to redistribute pressure and provide proper support.
- Proper footwear with adequate toe box space and good arch support.
- Taping techniques or splinting may be necessary for severe cases or those not responding to conservative treatment after 4-6 weeks.
Surgical Intervention
- Consultation with a podiatrist or orthopedic specialist is recommended for persistent cases to evaluate for possible surgical intervention.
- Surgical options may include tendon release, joint fusion, or other corrective procedures, depending on the severity and nature of the injury.
Complications and Considerations
- Restricted dorsiflexion is a common complication reported in the treatment of turf toe, a type of toe hyperextension injury 1.
- Low compliance and skin injury are potential complications of buddy taping, a method sometimes used in the treatment of finger and toe injuries 2.
- The anatomy of the lesser toes is complex, and surgeons should be aware of the high propensity for metatarsophalangeal joint hyperextension deformity in lesser toe surgery 3.