Hammertoes

A hammer toe is a toe that is bent downward at the middle joint and often the joint at the tip of the toe.

The deformity is caused when an imbalance occurs between the two sets of muscles that cause the toe to flex or extend. When one set over powers the other the deformity occurs. The deformity initially starts as flexible. Due to the progressive nature of the deformity over time it will become rigid or non-reducible.

Causes:

• Hereditary – you inherited a tendency to develop a hammertoe because your foot is not stable. Common with people with flat feet but can occur in individuals with a high arched foot.
• Injury to the toe can also cause hammer toes. Repetitive injury due to poor fitting shoes or fracture of the toe can lead to the deformity.
• Diseases of the joints can result in the deformity such as osteoarthritis or rheumatoid arthritis.
• Diseases of the nerves and muscles such as diabetes, disc disease of the back and stroke can result in the deformity.

Symptoms:

Hammer toes are typically painful due to shoe pressure.  Pain can be present at the tip or the top of the toe.  Pain may also occur in the ball of the foot due to a condition called reversed buckling.

Prevention:

• Proper shoe gear.
• Adequate arch support.
• Deep and wide toe box.
• Avoid pointed toes.
• Length of the shoe should be 3/8” to 1/2″ from the LONGEST toe.
• Avoid high heels for any extended periods of time.
• For deformities that are still flexible or reducible, stretching exercises may help.  Gently pull the toe to stretch the bent toe in the opposite direction.

Treatment:

Treatment is designed to limit irritation of the toe.  This can be achieved by conservative and surgical options.

Conservative treatment options include:

• Changes in shoe gear
• Over the counter innersoles or orthotics with metatarsal pad
• Topical pads made of foam, felt or silicone.  I like the silicone toe caps.
• Buttress pads work well in preventing the tip of the toe to hit the shoe.
• If the deformity is still flexible you can tape the toe.
• Lubrication of the friction points can help slow down the development of thickened skin.
• Padded socks can also decrease pressure.

Avoid use of chemical corn removers or the cutting of corns especially if you are diabetic, have circulation or immunity problems.

Surgical treatment designed to straighten the toe:

Should conservative options fail to alleviate the condition there are surgical options available. If the deformity is still flexible tendon work alone may be an option. Once the deformity is rigid tendon and bone work would be required at each level of the deformity. The toe may be fused to prevent reoccurrence especially if the deformity was due to a neuromuscular disease. A pin would be used to maintain the position.

*For products related to the treatment of hammertoe deformities we recommend footsupplystore.com

*To make an appointment with one of our physicians to evaluate your hammertoe deformity please call our office (numbers below) or fill out the contact form and we will contact you.