Quite some time ago I wrote about the “Little Toe Triangle.” Working recently at Badwater, I was reminded again about this little appendage. A runner had completed the grueling 135-mile Badwater race through Death Valley and had come into the medical room for foot care.
He really had pretty good feet. With on exception – his little toe on his right foot. A callus on the bottom of the toe had evolved into a substantial blister that had ruptured. The skin was movable from the bottom of the blister all along the inside of the toe to near the top, where the blister ended. There was no quick fix. The image here is not this runner’s toe, but very similar.
Removing the skin was not an option. I pulled the skin into place, added a dab of antibiotic ointment, and wrapped it with Coban self-adhering wrap.
Unfortunately, this runner was planning on running a 100-mile race this weekend. He and I talked about his options and I gave suggestion on how to manage the skin. I would doubt his ability to finish a 100 miler with this severely blistered pinky toe.
The number of problems with these little appendages has impressed me. “What problems?” you might ask. It’s all about that little triangle of skin where most problems occur.
If you look at your little toes, your toes may be well rounded and soft. Or they may have the often-typical triangle look where the skin on the bottom of the triangle is hard and callused. The skin on the bottom of the toe forms the point of the triangle. The problem is that on many of our little toes, this bottom point is hard and callused skin. The hard skin is prone to blisters forming underneath as pressure creates friction. Often this hardened skin is partially under the skin of the next toe, another pressure area. The outside of the foot, the little toe area, is often more wet and damp than the inside of the shoes, leading to macerated skin. Once softened, this skin can easily blister underneath, or worse yet, the skin can separate, leading to major skin problems.
One of the best ways to tame the callus on the bottom of the little toe is the Heel Smoother Pro. I reviewed this great tool last November. It comes with two tips. The smaller one is shaped like a little Christmas tree. The curved sides are perfect for toes. This is the best callus tool I have ever seen.
The little toe is so small that it is hard to patch well. The use of Micropore or Kinesio tape is a good choice. Even better, in my opinion, is reducing the hard callused skin. Injinji toe socks can also be helpful. Good shoes are vital too. Shoes with a good toebox that allows the toes room to wiggle are good. Once the skin has blistered, 2nd Skin is good to use as a patch. Cut it to fit the blister. Too much and it becomes bulky and rubs on the neighboring toe.
During a race or hike, be watchful of your little toes. This small but potentially troublesome triangle of skin deserves special care.
