Dislocating Toe?

[gcoe]

Exactly which toe joint dislocates and in which direction? How does this relate (if it does) to the hammer toe deformity? I presume it is the MTP dislocating in a volar direction?

It would be definitely worth looking at a movement impairment syndrome point of view. So have a good look at the length and weakness of the intrinsic foot muscles (likely to be weak) the extensor digitorum, flexor digitorum profundis and flexor digitorum superficialis (or the equivalent in the big toe if it is the big toe). Hammer toe is often due to weakness of the intrinsics (inability to flex the mtp while extending the ip joints) shortening or hypertrophy of the FDS muscle or the equivalent in the big toe) You could try a combination of muscle balance correction with splinting for several weeks.

If he is having all these musculoskeletal problems it may be worthwhile looking at movement impairments above the foot as well - a la Shirley Sahrmann

However to be honest by the time the ligaments have become so stretched that the toe dislocates - and there may now be other articular damage, it might be conservative measures isn't going to work. Things may have progressed too far in which case it is off to see the orthopaedic surgeon.

[RMTJosh]

Thanks for the input
to clarify in case anyone else has ideas, it is the index toe at the MTP joint of his left foot.
The plantar fasciitis came first, then hammer toe, and now he has started to get low back pain.
The back pain brought him in for Massage Therapy but the problem in the feet seems to be the starting point for the rest of the pain.