What are hammertoes?
Hammertoe is a common foot deformity that affects the second, third, or fourth toes, causing them to bend at the middle joint (proximal interphalangeal joint) into a hammer-like shape. This condition can start as a mild, flexible issue but may become rigid over time if left untreated, potentially requiring surgery. While the big toe typically has only two joints, the other toes have three, making them more susceptible to this type of misalignment.
Early intervention with proper footwear, stretching, and other conservative treatments can help prevent hammertoes from becoming a more serious problem.
What causes hammertoes?
A hammertoe develops from a muscle imbalance that puts pressure on the toe tendons and joints. Muscles typically work in pairs to straighten and bend the toes, but if a toe remains in a bent position for too long, the muscles and joints tighten, making it difficult to straighten the toe.
This is most commonly caused by wearing shoes that don’t fit properly. Shoes that are narrow at the toe push the smaller toes into a bent position. This causes rubbing and can lead to corns and calluses – these issues can make the condition worse.
Shoes with higher heels force the foot downward, increasing pressure on the toes and further bending them. Over time, the small muscles in the foot can weaken, leading to an imbalance that prevents the toes from straightening.
What are the symptoms of hammertoes?
A hammertoe can be painful, especially when the patient is moving it or wearing shoes. Symptoms of a hammertoe may include:
- Swelling or redness
- Inability to straighten the toe
- Difficulty walking
- A corn or callus on the top of the middle joint of the toe or on the tip of the toe
How do you fix hammer toes?
To fix hammertoes, your doctor will first perform a physical examination to assess whether the affected toe joint is flexible or rigid, which will guide the treatment approach.
Depending on the severity of the condition, doctors may require additional tests, like X-rays. Further testing may be necessary for patients with diabetes or reduced sensation in their feet to rule out any neurological conditions contributing to the tendon imbalance.
When should you see a podiatrist?
If you’re experiencing persistent pain, discomfort, or difficulty walking due to hammertoes, it’s time to see a podiatrist. Early intervention is important, especially if the condition is causing your toes to become increasingly bent or rigid. If you notice corns, calluses, or blisters forming on top of your toes, or if you’re having trouble finding shoes that fit comfortably, it’s crucial to consult a podiatrist.
Nonsurgical treatments for hammertoes
A hammertoe that still has a flexible joint can be treated by simple at-home measures. If you have diabetes, poor circulation, or numbness in your feet, consult your doctor before trying any self-treatment.
Changes in footwear
Avoid tight, narrow, high-heeled shoes and choosing ones that are one-half inch longer than your longest toe, with a soft, roomy toe box. Shoes with a deep toe box or a stretched toe box from a shoe repair shop may also provide relief. Sandals may help as long as they don’t pinch or rub other areas of the foot.
Strengthening your toes
Exercises that stretch and strengthen the muscles in your foot can be a simple way to mitigate a hammertoe in its early stages. These may include manually stretching your toes, using your toes to pick up objects, or doing “towel curls.” To perform towel curls, place a towel flat under your foot and use your toes to scrunch it.
Over-the-counter remedies
Over-the-counter straps, cushions, or nonmedicated corn pads can help alleviate pain.
Surgical treatments for hammertoes
If the toe joint becomes rigid and immovable, or if nonsurgical treatments fail to relieve your symptoms, you may require surgery. The procedure is typically done on an outpatient basis using a local anesthetic, with the approach depending on the type and severity of the deformity.
Volunteer Podiatry expert surgical care, tailored to each patient’s specific needs, to restore function and reduce pain.
Tendon lengthening
For patients with a flexible toe joint, the condition is often treated by lengthening the tendons that are contributing to the joint imbalance.
Tendon transfer
For some patients with a flexible toe joint, treatment may involve transferring tendons from the bottom of the toe to the top to help straighten the joint.
Arthrodesis (joint fusion)
For patients with a rigid toe joint, tendon lengthening combined with arthrodesis may be recommended. During this procedure, your doctor will remove a small portion of bone from the toe joint to allow for full extension. An external wire, pin, or internal plate will be used to hold the bones in place while they fuse together.
Post-surgery, you may experience some stiffness, swelling, and redness in the toe for up to 4 to 6 weeks. Although you can put weight on your foot right away, it’s important to limit activity during the healing process. Elevating your foot will help reduce pain and speed up recovery.
Once healed, your toe may be slightly longer or shorter than before, and the fused joint will no longer bend.