Physiotherapists in Homerton 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.

Flat Feet

It is common for patients to present with progressive flat foot deformity, also known as pes planus. However, despite it being common there the causes and treatments are still under debate. Adult acquired flat foot is most likely to be caused by an imbalance between the active arch maintenance structures and the passive arch maintenance structures. The foot may have been normal at some stage and something has changed to bring on the process of flattening of the arches. The posterior tibial tendon plays a strong role in actively maintaining the inner arch and a dysfunction or weakness of this structure is thought to be important in flat foot.

However, the ligaments binding the medial arch together and maintaining its structure may also be deficient in some way, leading to flat foot problems. The spring ligament, a strong ligament running between the calcaneus (heel bone) and the navicular, supports the head of the ankle bone (talus) and stops its slipping downwards, thereby maintaining the arch of the foot. Deficiency of this ligament complex is thought to be equally important to problems with the posterior tibial tendon. Treatment typically starts with insoles and modified footwear and progresses to foot surgery.