OverviewThe term, Hammer toe is used to describe the collective physical deformity of the second, third and fourth toe on a person's foot when they are permanently bent at one or two of their joints, often times at their middle joints or, 'proximal interphalangeal,' joints. The condition is also referred to as, 'contracted toes,' and earned its name for the resulting bowed appearance of the toes that made them appear similar to hammers. The distortion of the usual contour of the person's toes is usually a result of wearing shoes that are too short or narrow and apply consistent pressure to the toes, forcing them to be pushed together and lie obliquely. The situation is particularly true in the case of shoes that are designed to narrow towards the toe box.
Causes
Hammertoe commonly develops because of structural changes that take place over time in the muscles and tendons that bend the toes. People with certain medical conditions, such as diabetes, are at risk for developing hammertoe. It can be an inherited condition for some people. Other causes include trauma and wearing shoes that are too tight, narrow, or have high heels. The toe next to the big toe (second toe) is most frequently affected by hammertoe.
SymptomsPeople who have painful hammertoes visit their podiatrist because their affected toe is either rubbing on the end their shoe (signaling a contracted flexor tendon), rubbing on the top of their shoe (signaling a contracted extensor tendon), or rubbing on another toe and causing a painful buildup of thick skin, known as a corn.
Diagnosis
Hammertoes are progressive, they don?t go away by themselves and usually they will get worse over time. However, not all cases are alike, some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.
Non Surgical Treatment
A person with hammer toes will be asked to practice some exercises for their toes to regain average structure and movement. The exercises usually involve stretching and strengthening their toes. The person may attempt to pick things up off the floor using only their toes. They may also stretch their toes on a regular basis by hand to ease them into straightening out. Another example of a physical exercise specifically for a person's toes involves crumpling a towel with the toes. The towel can lie underneath the person's feet and the person can use their toes to scrunch up the towel as they perform simple tasks such as reading a book or watching television.
Surgical Treatment
In more advanced cases of hammer toe, or when the accompanying pain cannot be relieved by conservative treatment, surgery may be required. Different types of surgical procedures are performed to correct hammer toe, depending on the location and extent of the problem. Surgical treatment is generally effective for both flexible and fixed (rigid) forms of hammer toe. Recurrence following surgery may develop in persons with flexible hammer toe, particularly if they resume wearing poorly-fitted hammertoe shoes after the deformity is corrected.
PreventionIn addition to wearing proper shoes and socks, walking often and properly can prevent foot injury and pain. The head should be erect, the back straight, and the arms relaxed and swinging freely at the side. Step out on the heel, move forward with the weight on the outside of the foot, and complete the step by pushing off the big toe. Exercises specifically for the toe and feet are easy to perform and help strengthen them and keep them flexible. Helpful exercises include the following. Raise and curl the toes 10 times, holding each position for a count of five. Put a rubber band around both big toes and pull the feet away from each other. Count to five. Repeat 10 times. Pick up a towel with the toes. Repeat five times. Pump the foot up and down to stretch the calf and shin muscles. Perform for 2 or 3 minutes.
