Physiotherapists in Chesterfield treat many different conditions including the issues profiled below.

Hammer toes

Hammer toes are a common deformity of the foot and often associated with more profound changes in the foot such as pes cavus where the inside foot arch is exaggerated. The small intrinsic foot muscles, which allow the toes to be kept straight as they grip the ground, weaken and the extensor muscles then pull the near part of the toe upwards. This makes the near joints of the toes bend up leading to a clawing of the toes. The extensor tendons can then shorten, leading to a permanent deformity where the person cannot get the toes flat down onto the ground any more.

There are a series of consequences from this deformity. The toes curl up and thereby take up much more room at the end of the shoe, causing the tops of the joints to suffer pressure against the shoe and develop sore areas or calluses. A more spacious toe box in the shoes can relieve this. The metatarsal heads suffer increased pressure from weight bearing and also develop calluses under the ball of the foot where the loading is greatest. In time these changes can lead to foot pain and require stretches or surgical correction.

Joint Position Sense (JPS)

Joint position sense, also called proprioception, is the ability of the brain to sense the positions of the joints and segments of the body and the degree of muscle contraction being exerted at any point in time. It is a precise sense and we rely on it to move about accurately, with loss of the JPS causing us significant difficulties. The brain relies on the incoming information from the muscles, ligaments and joints to understand where the body is and thereby to plan what the next movement requires in terms of direction and muscle activity.

Loss of any degree of proprioception causes the person significant problems with understanding where they are and how to perform the next movement safely and successfully. It is much more disabling than a loss of muscle power alone and requires that they pay much more visual attention to their position and the outcomes of each new attempted movement. Physiotherapists work routinely with people with proprioceptive loss to restore this sense after operation or stroke. Gym exercises prescribed by physios include standing on a wobble board and performing activities such as bouncing and catching a ball against a wall. Restoration of JPS is vital before return to sport.