Dislocations are tears in the soft tissue which holds a joint together, and keeps it straight. This soft tissue consists of the joint capsule, ligaments, and tendons which can be ripped during an injury. This allows the joint to become unstable, and the toe bones move and become misaligned, or crooked. Signs of dislocations after an injury are: pain, swelling, ìblack and blueî discolorations, and a crooked toe.
If the pain is intense, an open wound is present, if bone is visible, the toe is cold and pale or blue, go to the emergency room immediately. If you have diabetes, poor circulation, bleeding disorders, or other generalized diseases, you should see a doctor immediately or go to the emergency room.
If you are not sure of the extent of your injury, see a doctor immediately!
Some diseases make even minor injuries very dangerous. If you are in good health and sustain a toe injury, then please continue reading
Self treatment must begin immediately after the injury, with a careful examination of the toe:
- The misalignment of the toe is at the joint (knuckle); and, the amount of "crookedness" present is minimal. If the pain is minimal, you can try and correct the dislocation yourself with a "gentle tug" on the toe. All dislocations must be re-aligned, or you may have difficulty wearing a shoe for the rest of your life. If it is too painful to do yourself with a "gentle tug," or it still is not straight, go to the emergency room immediately.
- If you are able to get the toe straight, keep it straight by using a cotton ball as a splint; and with minimal pressure tape the toe to the cotton ball. If the pain increases, or the toe turns pale or blue, or if it becomes cold, remove the tape immediately — it is too tight. If you cannot keep the toe straight, go to the emergency immediately, as this is an unstable dislocation, and requires medical care.
- Once the toe is straight, then continue self-treatment with "R.I.C.E.":
- Rest is very important. Take off your shoe, get off your feet, and relax.
- Ice should be applied as soon as possible. Never apply ice directly on the toes, as the small blood vessels in the toes can easily go into spasm when subjected to extreme cold. This can stop blood from getting to the toe, and is dangerous. Ice should be applied to the top of the foot, or front of the ankle, so that as the blood flows under the ice, it will be cooled. This cool blood flowing into the toe will help to reduce the swelling and pain. Apply the ice, wrapped in a cloth or over an elastic bandage, to the foot for 30 minutes, every 2 hours, for the first 3 days after an injury. If the ice is uncomfortable or causes increased pain, do not continue to use it; see a doctor.
- Compression is used to limit swelling, and to give support to the injured area. Compression should be applied to the entire foot. If it is applied just to the toe, increased swelling will occur behind the toe, or in the forefoot. Compression should be applied with a 3 inch elastic bandage, begining around all the toes, and then going around the foot and ankle.
Before you begin wrapping, make sure the toe is lightly taped to the cotton ball, so it will remain straight. The bandage should not be so tight that it causes increased pain or throbbing in the toes or foot. It should be comfortable! Do not remove the elastic bandage for the first 12 hours, unless it becomes to tight, or the pain increases, or the toes become pale or blue and cool. If any of these things happen, immediately remove the bandage and leave it off for several hours. The normal color and temperature of the toes should return immediately. If not, see a doctor immediately! Continue until the swelling and pain subsides; it could take several days.
- Elevation of the leg will aid in reducing swelling and pain. Blood rushes to an injured area to bring increased blood cells which aid in healing. Gravity will also force blood to the injured area. Too many cells and too much fluid will apply pressure to the injured nerves and tissues, and cause increased pain, and delayed healing. Keep your foot elevated so that it is at least parallel to the ground, or higher if it is comfortable. Do this for at least 48 hours, or until the throbbing subsides when you lower the leg.
- Healing will occur more quickly if there is no pressure on the injured toe. Our Injury Shoe is designed to keep all pressure off of the toes and forefoot area, and allows you to walk without bending the painful toe. This shoe will decrease healing time and pain. In 30 years of private practice, I have found that this shoe will reduce healing time by half, and allow you to be more comfortable while healing is occurring. We will ship this shoe to you by Priority Mail, at no additional charge.
- After the first 48 hours, and if it is comfortable, apply a small amount of cotton between the injured toe and the next toe. With half-inch strips of tape, tape the two toes together, very gently. Do not apply the tape with any pressure; keep it loose. The idea is to reduce movement of the injured toe, not to bind it tightly to the adjacent toe. If the discomfort increases, or the toe becomes pale, blue, or cold, the tape is too tight and it must be removed immeditely! For easier application and greater comfort, use The Digit Wrap. The Digit Wrap, is used to splint 2 adjacent toes together. Click here for more information.
- Do the above for at least 3 days. If there is no improvement, see a podiatrist immediately. If you see gradual improvement, continue the above course of treatment until the pain and swelling are gone. It can take bone and joints 4 to 6 weeks to heal, so be patient!