Curly Toes

This is a common condition that is usually present at birth (congenital) but can become more noticeable when your child starts walking. It tends to affect the third, fourth and fifth toes on one or both feet.

The movement of our toes is controlled by tendons which run from the ankle to the tips of the toes. Congenital curly toes usually develop because these tendons pull the toe under the next toe, curling it towards the underside of
the foot.

Occasionally the tendons can become tight and pull the tip of the toe underneath the next toe and towards the sole of the foot. We do not know exactly what causes this tightening, but it has been noted that the condition can affect several generations, which implies that it is passed on from parent to child (inherited). It has been suggested that the tendons become tight during rapid periods of growth.

The main symptom is the visible curling of one or more toes underneath the next toe(s). In the majority of children and indeed adults, curly toes do not cause any problems.

Occasionally some children complain of rubbing or pain and may develop areas of hard skin on the sole of the foot. Parents may have problems with
finding suitable shoes that fit properly.

• Curly toes rarely need any treatment and they do not affect walking or running.
• The use of strapping and taping for babies has been used extensively in the past however up to date research and clinical experience has shown this to be of little/no benefit.

Keeping toes flexible and supple will help. Stretching the toes out straight when drying them after bath time is an easy thing to do and implement into a daily routine. Toe spacers/separators, which can be bought in the chemist or from the internet, may also help hold the toes apart and prevent rubbing.

These however are not tolerated quite so well in younger children. Always ensure your child is wearing good supportive shoes that have been properly fitted, allowing lots of room at the toes so they can spread evenly. A small number of older children may benefit from wearing insoles in their shoes.

When to see your GP:

• If the toes are causing painful blisters or rubbing, callouses or ingrowing infected toe nails.
• Your GP may make a referral to an orthopaedic surgeon.
• The orthopaedic surgeon may suggest an operation which can be performed on the underside of the toe to release the tight tendon.
• Very rarely, if all of the toes of one or both feet are clawed, as if gripping an object and the in-step is particularly high, there may be an underlying neurological cause that requires further investigation, usually an MRI scan.
• Treatment for these feet varies significantly from that of curly toes, and is tailored depending on the underlying diagnosis.
• If your child is experiencing painful rubbing of infected toe nails or all of the toes of the foot are clawing then go to your GP.