Causes, treatments, and tips for curled toes after stroke
Why Do Your Toes Curl?
Curled toe, or claw toe, is a symptom of spasticity in your feet and toes.
It’s the result of miscommunication between your brain and your muscles.
The muscles in your foot are over-contracting due to the neurological impact of your stroke, and this causes your toes to curl when you don’t want them to.
Curled toes can occur at unpredictable stages, ranging anywhere from a few months to several years post stroke.
Curled toes can make walking painful, and there are a few treatment options that you can consider to help alleviate this stroke side effect.
Treatment for Curled Toes after Stroke
From least invasive to most, these treatment options can help fix curled toes.
The most noninvasive and effective treatments for curled toes are rehab exercises. Rehab exercises retrain the brain to control the muscles in your feet that are causing the spasticity.
The more you exercise the muscles, the more control you will regain, and eventually your brain will regain enough control to say, “Relax!”
And your muscles will be able to hear it.
Try these exercises for curled toes at home.
ANKLE FOOT ORTHOTICS
When rehab exercises are not an option, then ankle foot orthotics (AFO’s) can help realign stubborn piggies.
AFO’s come in the form of leg braces and shoe inserts that support proper alignment. For curled toe, you should look for AFO’s that have built in toe crests and metatarsal pads (little cushions for the ball of your foot). This will help reduce pain and increase comfort.
AFO’s can also be used for foot drop, a condition where you can’t properly lift the front part of your foot.
Transcutaneous Electrical Nerve Stimulation therapy involves electrical stimulation to your nerves and muscles. TENS therapy works by making you more aware of the subtle muscle contractions in your affected limbs, and it works best in conjunction with rehab exercises. Consider it an extra boost.
Botox is the only FDA-approved treatment for upper limb spasticity after stroke. However, many survivors have convinced their doctors to try Botox in their legs and some have seen improvement. So talk to your doctor about this option and see if they’re willing to try something new to help with your curled toes.
Unfortunately, this relief only lasts for a few months, so survivors who choose this treatment option may find themselves needing repeat injections.
In extremely painful cases, you can have surgery to cut the tightened tendons in your feet to relieve curled toes. This is the last resort though, as the surgery is irreversible.
4 Tips for Living with Curled Toes
Sometimes TENS therapy and Botox aren’t an option (or they don’t work), and AFO’s can take a couple months to get made.
Here’s what you can do in the meantime:
1. Stretch your toes to keep the tendons as lengthened as you can.
Avoid this if it’s too painful, but once those tendons shorten, it’s hard to reverse.
2. Try some toe separators when you’re at home.
Yes, the cheap foam beauty salon tools that you use to keep your toes separated while manicuring. Using toe separators can help reduce the pain of curled toes.
3. Use toe cushions in your shoes when you’re out and about.
Toe cushions are like little pillows for your toes that comfortably go inside your shoes and reduce the pain.
4. Get a pair of magnetic gel insoles.
They helped stroke survivor James Pribish reduce his curled toes. You can also cut the gel insoles up to protect your toes from painfully rubbing around in your shoes.
And when all else fails, it’s possible that curled toes can go away on their own in time.
How have you dealt with curled toes?
Did you have success with treatment or have you developed some tips of your own?
Share your experience or advice with our community in the comments below!