Polydactyly: Understanding the Rare Phenomenon of a Sixth Toe

Written by Brittany Stuckless on September 21, 2023

Polydactyly is a rare genetic foot condition that causes a sixth toe (and toenail) to grow as the last toe on the foot, next to the pinky toe. However, the sixth toe can sometimes be in the center of the toes or next to the big toe. The sixth toe is often called a digit (dactyl), with “poly” referring to “many.”

Today we’re going to answer all your questions regarding this rare condition, including:

What are the causes of polydactyly?
How does polydactyly affect foot health?
How can you manage polydactyly?

Close up of newborn toes no polydactyly — Photo by Daisy Laparra on Pexels

Causes of Polydactyly

Polydactyly is more common in children. This is because many adults will have had the sixth digit removed during their toddler years. Outside of genetics and genetic diseases, there are no known causes. A child can also be born with a sixth digit for no reason.

How Does Polydactyly Affect Foot Health?

Polydactyly does not usually cause foot pain.

As far as toe conditions go, the main issue is finding accommodating footwear. Patients may need to search for specialized shoes and medical shoes. The emotional toll a condition like polydactyly can take on a person may be more pressing than the physical toll, and can lead to self-esteem issues.

Young girl curious about feet — Photo by FreePik

How to Manage Polydactyly

Managing polydactyly often involves simply removing a child’s sixth toe.

Many sixth digits develop poorly and don’t look the same as other toes and fingers. These are generally removed via in-office excision (more common for extra fingers) or surgery under anesthesia (more common for extra toes).

If parents of children with a sixth digit wish to remove it, they should seek surgical intervention when the child is around one or two years old. This allows the bone to grow to the point where the cosmetic outcome is more favourable. This is also a good age since your child will likely not recall having this problem later in life and, according to Boston Children’s Hospital, can tolerate anesthesia more than an infant.

Children who’ve had a sixth toe removed should get regular chiropody care after they recover from surgery. If you’ve had a sixth toe removed as a child, you should also seek regular chiropody care into your adult years. Services like gait analyses, custom orthotic fittings, callus and skin care, and more can ensure foot health is on the right track.

Baby feet in white bed. — Photo by jcomp from Freepik

Is Your Child Recovering From Polydactyly Surgery?

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About Author: Brittany Stuckless

Brittany holds a Bachelor of Arts in English Language and Literature from Memorial University of Newfoundland. With a diverse background in journalism and marketing, she got her start as a freelance content writer. She currently works as a Marketing Assistant at Real Food for Real Kids in addition to her role as a writer at Feet First Clinic. Previously, Brittany has been a journalist for the Ontario Learning Development Foundation and Immigrant Muse magazine, and an Administrative and Marketing Assistant at Evolve Chiropractic and Physiotherapy. Originally from Newfoundland, she has lived in Toronto since 2014.

Learn more about Brittany Stuckless

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October 7, 2024

5 Ways Orthotics Can Be Customized for Maximum Comfort and Support

Many people don’t know what goes into their custom orthotics – not just the materials, but the technology that creates a comfortable orthotic. In this post, learn about all the different accomodations and orthotic customizations available to make your feet happy! https://www.youtube.com/shorts/IBXAXoUouFY?feature=share What Are Orthotic Customizations and Accomodations Additions and Accommodations are very common parts of custom orthotics. They are used if a normal over-the-counter insole just won’t cut it. For example, if a patient has a neuroma or a misaligned gait, an orthotic without custom support won’t have anywhere near the same effectiveness. Here is a list of the most common orthotic customizations and accommodations for custom orthotics. Heel Modifications Firstly we have heel modifications. These are some of the most common additions to keep your feet comfortable and supported: Cushion – Adds additional padding and shock absorption on the heel. Heel cushions cover the whole heel. Cushioning the heel is helpful for a variety of foot conditions, like plantar fasciitis and arthritis. It essentially reduces the strain and impact of your step. Lift – Heel lifts can balance out differences in leg height and to prevent overpronation or supination. They can also be used to help with Achillies tendonitis. They're made of a harder material for balance. Hole – Heel holes are used to help with heel spurs. Cushioning can be added to increase comfort and distribute pressure in the heel. Seat – A Heel seat gives the patient more control if they overpronate. It's designed to hold the fatty tissue under the calcaneus in place. Metatarsal Modifications These orthotic customizations are designed to take pressure off of your metatarsals (the ball of your foot). They are helpful for anyone experiencing foot pain at the ball of their foot just below the toes. 1st Ray Cutout - Helps to offload pressure off 1st metatarsal head (the big toe). This is used to help with bunions and arthritis. 2-4 Metatarsal Pad – This is a teardrop shaped pad that sits below the metatarsals. It takes some of the load off the metatarsals by offloading pressure at ball of foot and elevating the second, third, and fourth metatarsals. Metatarsal Bar – This is similar to 2-4 metatarsal pads, but has more surface area and offloads more pressure from the metatarsal heads. It can provide more stress relief in some cases. Neuroma Pad – This is a small pad that sits between metatarsals and spreads them apart. It is designed to correct the transverse arch and help with pain in the metatarsals. As the name suggests, it is can help people experiencing a Morton's neuroma. Arch Support Moving on, we have arch support, which is important for everyone - regardless of whether you have a foot condition - but moreso for people who struggle with plantar fasciitis and arch pain. Arch Pad – Additonal support on the arch for patients who need more arch support. Fill – Arch fills make the orthotic more rigid. This is used to help the orthotic to support more weight. It can also be used to help somewhat with controlling the midtarsal joints. Additional Accommodations Finally, we have modifications that don't really fit into the previous categories. These are all very common additions that are often put in orthotics: Morton’s Extension – Extra length under 1st metatarsal to keep it rigid. It helps during the push off phase of gait and can be rigid if patient has hallux rigidus or limitus. It immobilizes and offsets pressure on the first met joint. Reverse Morton’s – This increases the mobility of the first met joint. The pad sits under the 2nd to the 5th met head and ends before the first. Dancer Pad – Offloads the ball of the foot. It works by taking weight off of the big toe joint and dispersing it. Scaphoid Pad - This is used to help support the mid and back foot. Helps take pressure off the joints and bones in the arch. While these are the most common accommodations found on orthotics, there are many more! To learn more about how orthotics can be modified and customized to suit your unique foot needs, check out this Website. What Orthotic is Right For Me? A licensed chiropodist can determine what orthotic customizations and features are best for you. The chiropodist would first do a biomechanical assessment and gait analysis. They'll then diagnose your foot condition and make recommendations. Remember - orthotics are just one part of the equation when it comes to treating foot pain. While they can be beneficial for many common foot conditions, it's recommended to also explore other treatment options first, like supportive footwear, exercises and stretches. If your chiropodist recommends orthotics, they'll discuss the different options and customizations available, and which ones will work best for your foot condition. They'll also take into account your activities and the footwear you'd be wearing the orthotics with. The chiropodist will then take a 3D scan of your foot and send it off to the lab to make your orthotics. You would then see the chiropodist a few weeks later for a fitting appointment, at which time the chiropodist will check that the orthotics are constructed properly and working the way they should. If everything checks out, you can take them home! We also recommend coming back about 6 to 8 weeks after your fitting for a follow-up appointment to see if your orthotics are helping with your foot pain. If they aren't, the chiropodist can modify the orthotics. https://www.youtube.com/shorts/pO5oWb6S5MA?feature=share

October 3, 2024

The Importance of Proper Footwear for Kids in Fall: What Parents Need to Know

Are you wondering how much you need to invest in your kids’ foot health this fall? Not sure what all the fuss is about over getting the best fall shoes for children? While it may seem like your child’s summer shoes can last a little while longer, it’s important to take their foot health needs seriously and make sure they're set up for the fall. We’ve crafted this parent's guide to kids’ shoes in the fall to help you out! Keep reading to learn the main reasons why proper footwear for kids is essential during this beloved season. 3 Reasons Why Your Kids Need Fall Shoes They support back-to-school activities They protect feet from the elements They provide support for growing feet Support Back-to-School Activities Remember the excitement of getting a new pair of athletic shoes every year before that first day of school? Well, there’s a reason your parents did that for you! Many kids up their activity game during back-to-school season. The excitement of reuniting with friends, outdoor recess time, extracurriculars and gym class are all contributing factors to this healthy boost in physical activity. Thus, comfortable athletic shoes for children land inside the fall shoes realm. The best shoes for kids should encourage proper gait patterns. They also feature cushioning for shock absorption, which reduces stress on growing bones and joints during activities like running and jumping. Additionally, supportive footwear can prevent common foot problems such as blisters, calluses, and ankle injuries, the latter of which is a common injury for kids. It's important to ensure shoes have a snug (but not tight!) and secure fit, breathable materials, and a durable outsole for safe performance and comfort. If your child's shoes put pressure on the side of their feet, opt for wide-width shoes. Protect Feet From The Elements Shoes are always designed with seasonality in mind, and just like you need new fall boots, so do your kids. One of the reasons is the slowly declining temperatures and damp, cold conditions. While September and early October are often pleasant weather-wise in Toronto, November can bring sudden frigid air and freezing rain. Wearing the wrong shoes in this weather may cause foot problems like chilblains, or small, itchy swellings caused by poor circulation in response to the cold. Studies show it often targets teenagers. Additionally, shoes designed with weatherproof materials and proper ventilation help ward off bacteria and fungi. Lastly, fall shoes for children correlate with FALL prevention. Colder weather + rain = slippery sidewalks and even black ice formation. For these, your kids need boots with a solid grip. Provide Support For Growing Feet Did you know that children’s bone, muscle and joint growth continues until they reach their early twenties? Child foot development is both fascinating AND fast paced, so you need to keep on top of your child’s needs and assess how much their feet have grown or changed shape when the fall season rolls around. Properly fitted shoes with arch support and cushioning are crucial during growth phases to ensure healthy foot alignment and prevent long-term issues. Likewise, teaching good footwear habits during the foot development phase sets your child up for success! Wearing ill-fitting shoes now can lead to problems in their adult years, and may even cause deformities like bunions and hammertoes decades down the road. Here are our top tips to make sure your child's shoes fit properly: When putting shoes on, get your kid to kick their heel back before lacing or strapping up the shoe. This puts their foot is in the proper position, with the heel in the heel cup and the arch lined up with the arch support. Then use the laces or straps to secure the foot into that position. This will ensure your kid's foot doesn't slide forward when they walk, and also allows you to properly gauge their toe room. If your kid's shoe isn't put on properly, you won't be able to determine whether it fits. Leave about 1 cm of toe room at the end of the shoe. While it's good to leave growing room, it's important not to leave too much room. Otherwise, the shoe will slip and slide around your child's foot and not be secure. And a shoe that's not secure won't provide good support. If you see a gap at the back of the shoe or the shoe moves as your child walks, go down half a size, or make sure the shoe is put on properly (see above). Use the laces to adjust the width and fit. If your child feels pressure on the sides, try loosening the laces. Don't pull the laces too tight. Instead, gently adjust them to the width of your child's feet. If the shoe still feels tight and there's enough room at the end of the shoe, look for a wide width shoe. Don't size up if there already is enough room at the end; you'll just end up with a long narrow shoe.

September 30, 2024

Fall Footwear Trends: What’s Safe and Healthy This Fall

It's time to refresh your wardrobe with the latest fall footwear trends! While staying stylish is important, it's equally crucial to ensure your feet remain safe, comfortable, and healthy throughout the season. In this guide, we’ll explore the best shoe types and features that offer protection from the elements and minimize foot pain. The Best Fall Shoe Styles Just because safe fall shoes are practical, it doesn’t mean they can’t be fashionable. While shopping, look for designs that complement your wardrobe while still offering the comfort and protection you need. You also need to make sure your shoe always corresponds properly with your activity of choice. Also, consider specific needs: from seniors to children to construction workers, every foot is unique. Fall shoe styles for this season include: Foot-friendly fall ankle boots for everyday wear. These can be simple in style and include laces or easy slip-ons made mostly of leather with pull-tabs or pull-loops. But, there are also versions designed for fall adventures and challenges with extra shock absorption and waterproofing. Speaking of shock absorption and waterproofing, this also applies to running shoes and athletic shoes for fall. Look for extra traction to prevent falls and foot injuries on slippery wet surfaces and on your favourite trail excursions. Our top picks are the Saucony Excursion GTX or the ASICS Gel-Sonoma. They're both hiking shoes with great grip and cushioning. They have a Gore-TEX upper, which is both waterproof and breathable. The Saucony Excursion GTX Heeled or platform boots that pair with your favourite dressy attire. Combat boot with an elevated sole, like the Clarks Torhill Rise, are on trend. These boots are out there, and waiting to be worn with your best duds! Brand That Make Healthy Fall Footwear Our downtown Toronto foot clinic carries only the best-of-the-best trendy and comfortable shoes. These may rotate sometimes, so be sure to stop by or call to ask what we have in stock. We often carry these brands that make first-rate fall footwear: Saucony: A great source for waterproof hiking shoes to keep your feet dry in wet conditions. ASICS: Another great option for waterproof hiking shoes. They also make waterproof running shoes. Ara: Ara makes stylish cushioned dress shoes, waterproof ankle boots and winter boots for when the weather starts to turn. Clarks: Clarks carries an array of fashionable boots. Mephisto: Mephisto's All Rounder collection has a variety of ankle-hiking boots, like the Nigata-TEX and Satika-TEX. They also have some great waterproof walking shoes that are perfect for fall. More Fall Footwear Essentials to Consider: Shoes may steal the spotlight in fall footwear, but they’re not the whole show. Here are more fall must-haves: Orthopedic slippers you can wear inside: These are great for people with musculoskeletal conditions like plantar fasciitis, Morton’s neuroma, metatarsalgia, and more, because they often have moulded foot beds and deep heel cups to provide arch support. One example is the Aetrex Mandy (below). Custom orthotics or insoles to wear with your footwear:. Check that your fall shoes have removable footbeds to accommodate these. Compression stockings to stimulate blood flow and keep your feet extra toasty. Moisture-wicking socks to control foot odour and ward off fungal infections.

September 16, 2024

Understanding Different Types of Custom Orthotics: How to Choose the Right Support for Your Feet

You may have heard of custom orthotics before, (if not, check out this article) but did you know that there are many different types of custom orthotics? Orthotics range from sports orthotics to dress orthotics, and everything in between. In this article we will cover the different types of custom orthotics you can choose, and what might be best for your feet. Custom Orthotics Custom Orthotics are the most common type of orthotic. Easily accessible and slipped into shoes, these provide maximum support and can help with foot problems like plantar fasciitis or Morton’s neuroma. Custom orthotics are also ideal simply if you want more comfort and support when walking around during everyday tasks. All of the orthotics below are some kind of custom orthotic. You can also find many examples of these orthotics on this website. Sports Orthotics These orthotics are ideal for people who are often running, jumping, and doing high impact activates on a regular basis. Sports orthotics can be easily modified to fit the sport you're doing. For example, if you were a basketball player who Is doing lots of jumping, the orthotic would be made with extra shock absorption. Sports orthotics are designed to help with common sports conditions like plantar fasciitis. They are made semi-rigid to provide the optimal balance between comfort and control. Casual Orthotics If you enjoy going on walks but often have pain in your feet, casual orthotics may be the way to go. These orthotics are meant for walking and standing for long periods of time and can provide comfort that you may not otherwise get from your regular shoes. Casual Orthotics are also great because they are easy to transfer between shoes and are low profile, meaning they're relatively, so you can wear them with shoes that don't have removable insoles. Casual orthotics are typically rigid or semi-rigid depending on your foot condition. Dress Orthotics Like casual orthotics, dress orthotics are meant for long periods of standing and walking. The main difference between the two is the size. Dress orthotics are designed to be slimmer and fit into the smaller shape of dress shoes. Because of the limited space, some orthotics may have to sacrifice width and support; however they will still provide relief from uncomfortable shoes. Accommodative Orthotics: Accommodative orthotics are designed for people that have more severe issues with foot pain and comfort. This can include arthritis, foot deformities, and diabetes. They tend to have a soft and cushioned top cover. These orthotics are mostly flexible to be nicer on the feet, however they can also be semi-rigid if the user needs more control. Children's Orthotics Childrens orthotics differ from adults because children are growing constantly. Often, children are prescribed orthotics to correct an issue that would be present in their adult life if not corrected. Children may get several different pairs of orthotics as they grow older to accomodate their changing feet. Children's orthotics are made for comfort as well as correction, so that your little one can be comfortable running around. Conclusion There are many different types of orthotics available that can easily accomodate your footwear and activities. They're also a great way to upgrade your favourite shoes. Whether you want comfort or control, there is always an option for you.

September 9, 2024

Natural Remedies for Foot Pain: Home Treatments That Work

Sometimes, your feet need a little extra TLC, especially after long days or if you’re struggling with a painful foot condition. While a visit to your local foot clinic is always a good idea, remembering some natural remedies for foot pain can be a lifesaver when you need relief at home. Exercises, Stretches and Yoga Foot pain relief exercises are excellent for addressing discomfort and promoting overall foot health. On top of being effective, they are a holistic, natural foot care remedy. The best stretches and exercises target the muscles, tendons, and ligaments in the feet, helping to improve flexibility, strengthen weak areas, and increase circulation. When you practice these at home, you are doing your part to manage common issues like plantar fasciitis, Achilles tendonitis, bunions, osteoarthritis, general muscle soreness, and much more. Additionally, they are cost-effective (no expensive gym equipment required!) and designed to accommodate people with disabilities (many feature modifications). Here are some resources (keep in mind you can often mix and match exercises): Exercises for top of the foot pain. Exercises for plantar fasciitis. Exercises for bunions. Exercises for arthritis part 1 and part 2. Exercises for diabetes. Incorporating yoga into your routine is another effective approach to soothing foot pain. Yoga poses that focus on stretching and strengthening the feet, such as the Downward Dog and Warrior, not only provide relief from current pain but also help prevent future issues by improving foot alignment and balance. Read about the best yoga exercises for your feet here. Foot Bath A long bath at the end of a hard day is one of life’s greatest gifts. But a targeted foot bath is also one of the best natural remedies for foot pain. One of the key natural ingredients to use in your bath is epsom salt (it’s nothing like the salt you use for cooking!). Research suggests it relieves muscle cramping, prevents blood clots, and boosts nerve function. Foot soaks for purchase at our Toronto foot clinic may also help. Gehwol Fusskraft Herbal Foot Bath has several ingredients to soothe tired achy muscles. Click here to inquire! Be sure to warm water in your foot bath, as opposed to hot water. Water that is too hot can dry out your skin and cause discomfort during the foot bath. Foot Massages and Essential Oils A DIY foot massage is one of the best foot pain management tips, and it’s a treatment you can do 100% from home. Using essential oils with your massage is a herbal remedy for foot pain you can try. Some studies show that a mix of geranium, lavender, bergamot, tea tree, and eucalyptus essential oils helped reduce pain in people with diabetic neuropathy. Side note: It’s a common misconception neuropathy only causes foot numbness; it can also lead to sharp pains in the feet. These oils may also help with other foot conditions! Use a carrier oil, preferably coconut oil, and mix it with the essential oils for the best results. Learn how to perform a foot massage here.

August 29, 2024

Understanding Plantar Fasciitis: Causes, Symptoms, and Treatment Options

Plantar fasciitis, a condition that impacts the foot and the heel, is very common but often misunderstood. If you've felt sharp stabbing pain in your heel when you take your first steps in the morning, you might know this condition firsthand. But what does plantar fasciitis mean, and how can you treat it? Let's explore the specifics to help you better understand plantar fasciitis causes and treatments. What is plantar fasciitis? Plantar fasciitis happens when the plantar fascia gets inflamed. This thick band of tissue stretches from your heel to your toes along the bottom of your foot. It helps support your foot's arch and handles the stress we put on our feet. When this band gets irritated or swollen, it can lead to pain and discomfort. You'll often feel this pain in your heel area. Causes of plantar fasciitis Plantar fasciitis is typically caused by overuse and activities that put too much stress on the feet, which ultimately strains the plantar fascia. Such activities include includes running long distances, standing for hours, or playing high-impact sports. Risk factors that can make you especially vulnerable to developing plantar fasciitis include: Foot structure: Conditions such as flat feet or high arches can lead to unhealthy biomechanics (i.e.: overpronation), which can then can put extra stress on the plantar fascia when you walk. Improper footwear: Wearing shoes that don't support or cushion your feet well can make you more likely to develop plantar fasciitis. High heels, old shoes, or flimsy footwear without adequate arch support can all contribute. Getting older: Those aged 40-60 are more prone to plantar fasciitis, but it can happen to anyone at any age. It's one of many age-related changes to the feet we experience as we age. Your job: Working a job where you have to stand or walk on hard floors for a long time can increase your chances of getting this condition. That's right! Even your career can influence your foot health. Symptoms of plantar fasciitis The telltale symptom of plantar fasciitis is heel pain. In addition, you may experience the following: Quick-hitting pain: Pain is often most severe when you take your first steps in the morning, or after sitting for an extended period. This pain tends to decrease with continued activity but can return after rest. Sharp pain: Plantar fasciitis-related pain is typically sharp and may be felt near the heel's underside. Pain post-exercise: While activity may initially relieve the pain, it can worsen after exercise or at the end of the day. Tenderness: Pressing on the area where the plantar fascia attaches to the heel bone may cause pain. Treating plantar fasciitis You may experience pain with plantar fasciitis first thing in the morning. The good news is that most cases of plantar fasciitis can be managed with conservative treatments. Here are some effective strategies for treating plantar fasciitis: Rest and ice: Resting and applying ice to the affected area can help reduce inflammation and pain. Aim to ice your heel for 15-20 minutes several times daily. You may also benefit from over-the-counter anti-inflammatories like ibuprofen or naproxen, which can reduce pain and inflammation. Stretching exercises: Gentle stretching of the calf muscles, Achilles tendon, and plantar fascia can help alleviate tension and reduce pain. Exercises such as the calf stretch, towel stretch, and rolling the foot over a cold bottle or a tennis ball can be beneficial. Footwear: Wear supportive shoes with good arch support and cushioning. Avoid walking barefoot on hard surfaces, and consider using custom orthotic inserts to provide additional support. Read our dedicated blog post on the best shoes for plantar fasciitis. Night splints: Wearing night splints can help keep the plantar fascia stretched overnight, which may reduce morning pain. Avoid high-impact sports and activities: Temporarily reducing or modifying activities that exacerbate your symptoms can help prevent further irritation of the plantar fascia.

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Polydactyly: Understanding the Rare Phenomenon of a Sixth Toe

Causes of Polydactyly

How Does Polydactyly Affect Foot Health?

How to Manage Polydactyly

Is Your Child Recovering From Polydactyly Surgery?

About Author: Brittany Stuckless

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5 Ways Orthotics Can Be Customized for Maximum Comfort and Support

The Importance of Proper Footwear for Kids in Fall: What Parents Need to Know

Fall Footwear Trends: What’s Safe and Healthy This Fall

Understanding Different Types of Custom Orthotics: How to Choose the Right Support for Your Feet

Natural Remedies for Foot Pain: Home Treatments That Work

Understanding Plantar Fasciitis: Causes, Symptoms, and Treatment Options

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