Physiotherapists in Covent Garden 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.

Fatigue or Tiredness with Musculoskeletal Conditions

Tiredness or fatigue is an extremely common accompanying condition to a large number of musculoskeletal conditions. Patients may rate fatigue just as important and severe as their pain problems but there is little consensus on the diagnosis and treatment of this distressing condition. Fatigue has been studied in good quality trials of people with arthritic conditions. If fatigue is an issue it is commonly present in varying degrees from a low level of weariness to complete exhaustion. Fatigue may also be shattering and force the person to lie down and rest or sleep, is not necessarily related to activity at all and can involve cognitive faculties such as thinking and memory.

Tiredness interferes with all aspects of a patient.s life including employment, personal relationships, normal daily chores, looking after children, social life and leisure. Patients often save energy for essential activities such as work or chores at the expense of a social life or any kind of recreational activity. Typical consequences of this forced inability to participate in normal life are frustration, anger, resentment and depression. Fibromyalgia and chronic fatigue syndrome overlap in their presentation of pain and tiredness symptoms, with fibromyalgia typically exhibiting pain as its main symptom but accompanied sometimes by high fatigue levels.