What is Hammertoe?
Hammertoes are a deformity of the toes, usually the second, third, or fourth toes, where there’s bend at the middle joint; causing them to look like a hammer. This condition maybe caused by a muscle imbalance which puts pressure on the tendons and joints of the toe, leading to its contracted, or bent, position. The deformity can be flexible (where you can still move the toe at the joint) or rigid (where the joint is immobile).
Hammertoes can lead to discomfort and pain, especially when wearing shoes, as the bent toe might rub against the shoe. Over time, this can result in the formation of corns or calluses. Treatment options depend on the severity and flexibility of the hammertoe. They range from simple changes in footwear and orthotic devices to help redistribute pressure away from the affected toes, to exercises aimed at strengthening toe muscles. In some cases, surgery might be necessary to correct the deformity.
Major Causes of Hammertoes?
- Hereditary predisposition
- Relatively long toes
- Tight muscles
- Flat feet - Certain muscles overwork to hold and stabilize the foot and cause contractures of toes
- High arch feet - Same concept of flat feet with muscles overworking in a stabilizing manner
- Aggravated by improper fitting shoe gear shoe gear
- Often seen in conjunction with deformities such as bunions
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Signs and Symptoms of Hammertoes
Pain in closed shoes
Discomfort or pain when wearing closed-toe shoes. The shoes put pressure on the deformed toe, leading to increased pain, which can be a constant dull ache or sharp pain, especially when wearing tight or narrow footwear
Knuckles of the toes are prominent
The middle joint of the toe bulges outward, making the knuckles more pronounced. This is due to the toe bending abnormally at this joint, leading to a noticeable protrusion which can be easily felt and seen
Redness and swelling over the toe knuckle
There's inflammation at the affected joint. The skin around the toe knuckle may appear reddened and feel tender to the touch, often a result of the continuous rubbing and pressure from footwear
Toes start to overlap each other
In more advanced cases of hammertoe, the affected toes may start to overlap with adjacent toes. This is caused by the progressive bending of the toe, altering the natural alignment and potentially leading to more complex foot deformities
Hard skin over the toe
Known as corns or calluses, this thickened skin forms over the toe due to persistent friction and pressure. Corns typically develop on the top and sides of the toe where it rubs against the shoe, while calluses may form on the sole of the foot
Open Sores
In advanced or severe cases of hammertoe, particularly among individuals with diabetes or poor circulation, open sores or ulcers can develop on the affected toe
Hammertoes Treatment
- Change in Footwear - Wider shoes with high toe box (taller at front of shoe). Avoid high heels and tight shoes that can exacerbate the condition
- Custom Orthotics - Orthotic to balance out the low arch or high arch foot - this helps to reduce the muscles’ overload and pulling on the toes - this has benefit to not only prevent the contractures from worsening, but also to prevent recurrence after surgery, if performed
- Surgery - Surgical straightening of the toes to allow comfort when wearing closed shoes
- Exercises - Strengthening and stretching exercises for the toes can improve their flexibility and strength. For example, picking up marbles with the toes or crumpling a towel with the feet can be effective
- Splints or Straps - These can be used to realign the bent toe, especially in the early stages when the hammertoe is still flexible
- Medications and Cortisone Injections - Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to relieve pain. For more severe pain and inflammation, cortisone injections may be recommended. Remember to always your podiatrist before injecting any such prescription medicines
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