A Hammer toe
is a misshapen second, third, or fourth toe. The toe bends up at the middle joint. The toe
becomes a hammertoe because a muscle in the toe isn?t working properly or is too weak, increasing pressure on the tendons and the toe joints. Muscles normally work in twos to bend and straighten
toes. If the toe stays bent too long, a hammertoe develops. Ill-fitting shoes, arthritis, heredity, even an injury, can cause the hammertoe to form. To add insult to injury, corns and calluses are
common on top of hammertoes because the toe is rubbing against the shoe.
If a foot is flat (pes planus, pronated), the flexor muscles on the bottom of the foot can overpower the others because a flatfoot is longer than a foot with a normal arch. When the foot flattens and
lengthens, greater than normal tension is exerted on the flexor muscles in the toes. The toes are not strong enough to resist this tension and they may be overpowered, resulting in a contracture of
the toe, or a bending down of the toe at the first toe joint (the proximal interphalangeal joint) which results in a hammertoe. If a foot has a high arch (pes cavus, supinated), the extensor muscles
on the top of the foot can overpower the muscles on the bottom of the foot because the high arch weakens the flexor muscles. This allows the extensor muscles to exert greater than normal tension on
the toes. The toes are not strong enough to resist this tension and they may be overpowered, resulting in a contracture of the toe, or a bending down of the toe at the first toe joint (the proximal
interphalangeal joint) which results in a hammertoe.
The most obvious symptoms of this injury will be the the middle toe joint is permanently bent at an angle. In the beginning movement may still be possible but as time passes and the injury worsens
the toe will be locked in place and possible require hammer toe correction surgery to fix. Another key indicator of hammer toe is that a lump or corn will form on top of the toe. The toe joint will
be painful and walking can cause severe discomfort. Occasionally a callus may form on the sole of the injured foot. If you see any of these symptoms together or have been enduring pain for some time,
seeing a podiatrist should be your next step.
Some questions your doctor may ask of you include, when did you first begin having foot problems? How much pain are your feet or toes causing you? Where is the pain located? What, if anything, seems
to improve your symptoms? What, if anything, appears to worsen your symptoms? What kind of shoes do you normally wear? Your doctor can diagnose hammertoe or mallet toe by examining your foot. Your
doctor may also order X-rays to further evaluate the bones and joints of your feet and toes.
Non Surgical Treatment
Pad it. Mild cases of hammertoe can be treated with corn pads or felt pads available in the pharmacy. Toe caps, the small, padded sleeves that fit around the tip of the toe, may relieve hammer toe
pain. Change your shoes. Wear wide shoes with resilient soles. Avoid shoes with pointed toes. Exercise. Certain exercises such as moving and stretching your toe gently with your hands and picking
small or soft objects such as marbles or towels can keep your toe joints flexible. Also, while you are watching television or reading, you can also put a towel flat under your feet and use your toes
to crumple it. This simple exercise can stretch and strengthen your muscles. Use ice. If your hammer toe becomes painful, applying an ice pack several times a day can help relieve the soreness and
Take medications. Nonsteroidal anti-inflammatory medicines (also called NSAIDs), such as ibuprofen or naproxen may be helpful hammertoe
in minimizing pain and inflammation. Use orthotic devices. Place a custom orthotic device
in your shoe. This will help control the muscle/tendon imbalance.
There are several surgical techniques used to treat hammertoes. When the problem is less severe, the doctor will remove a small piece of bone at the involved joint and realign the toe joint. More
severe hammer toes may need more complicated surgery.