Hammertoes

What are hammertoes?

A hammertoe results when ligaments, tendons, and muscles around the toe joint get out of balance, causing the toe's middle joint to buckle and get trapped in this position. This condition is most likely to happen with the middle three toes.

There are two kinds of hammertoes, including:

• Flexible Hammertoes. The toe can still move at the joint. This is great because the problem is mild, and several treatment alternatives are available.
• Rigid Hammertoes. If the tendons within the toe feel rigid, the joint has been pushed out of alignment, and the toe cannot move. Surgery is the only treatment.

What causes hammertoes?

Hammertoes are caused by abnormal muscle balance within the toe, which puts additional strain on the joints and tendons. Muscle imbalance can result from several factors, including:

• Genes: If relatives have hammertoes, you may be more likely to develop this condition.
• Shoes: High heels, narrow shoes, and shoes with pointed toes can all contribute to developing hammertoes.Arthritis or diabetes: These conditions can lead to nerve damage in the feet that results in muscle imbalance.
• Trauma: An injury can cause the toe muscles and joints to get out of balance.
• Neuromuscular Disease:  Patients with conditions like cerebral palsy, muscular dystrophy, and Charcot-Marie-Tooth disease are more likely to develop hammertoes since they can weaken the muscles and tendons around the toe joint.
• Arthritis: Arthritis can lead to the development of hammertoes as it changes the way you walk.

What are the symptoms of hammertoes?

Patients with hammertoes frequently complain about their feet hurting when they walk or try to stretch or move the affected toe. Hammertoe symptoms include:

• Claw-like toes
• Calluses or corns
• Swelling at the joint
• Challenges walking
• Pain the ball of the joint
• Inability to twist the toes or flex the foot

How are hammertoes diagnosed?

We can diagnose hammertoe through physical examination, which includes moving and touching your toes and feet to see how the joints react. We can order X-rays if necessary to further evaluate the bones and joints of your feet and toes.

We recommend that diabetic patients undergo a series of tests to determine whether an underlying neurological condition is causing a tendon imbalance.

How are hammertoes treated?

If your toe is still flexible, we may advise you to wear larger, more comfortable shoes and orthotics (shoe inserts) or pads. Custom Orthotics assist in repositioning your toes and relieving pressure.

We also recommend exercises like collecting marbles or creasing a piece of cloth with your toes to stretch and strengthen your leg muscles.

Surgery may be required if the toe is rigid and not responding to these conservative measures. Surgery for hammertoe involves straightening the toe by removing the abnormal bone. Dr. Hassan may also need to release or lengthen tendons and ligaments.

After surgery, you will likely need to wear a surgical shoe for four to six weeks. Physical therapy may also be necessary.  

Can hammertoes be prevented?

Hammertoes can be prevented by taking the following actions:

• Wear Comfortable Shoes:  Avoid high heels and shoes with pointed toes. Look for shoes with a wide-toe box.
• Exercise: Stretch your muscles and tendons daily, especially those in your feet and legs.
• Stop Smoking:  Smoking can lead to poor circulation, contributing to hammertoes.
• Check Your Feet Regularly: Inspect your feet regularly for any changes or problems. 
• Be Careful with Bunions: If you have bunions, be careful not to let them get worse. Hammertoes are often the result of progressive deformity from bunions.

Can hammertoes cause other problems?

A hammertoe can initially maintain its flexibility. However, the tendons in the toe will eventually contract and tighten, causing the toe to become permanently curved. Shoes can cause painful calluses and corns by rubbing against the raised portion of the toes.