Many disorders can affect the joints in the toes, causing pain and preventing the foot from functioning as it should. A Hammer toe
occurs when the joint at the end of the toe cannot straighten.
Excessive rubbing of the hammer toe against the top of the shoe can lead to pain and the development of a corn. The tip of the toe is often turned down against the shoe causing pressure and
A common cause of hammertoe and mallet toe is wearing improper footwear - shoes that are too tight in the toe box, or high-heel shoes. Wearing shoes of either type can push your toes forward,
crowding one or more of them into a space that's not large enough to allow your toes to lie flat. Hammertoe and mallet toe deformities can also be inherited and may occur despite wearing appropriate
footwear. The result is a toe that bends upward in the middle and then curls down in a hammer-like or claw-like shape. Your shoes can rub against the raised portion of the toe or toes, causing
painful corns or calluses. The bottom of the affected toe can press down, creating the mallet-like appearance of mallet toe. At first, a hammertoe or mallet toe may maintain its flexibility and lie
flat when you're not wearing crowded footwear. But eventually, the tendons of the toe may contract and tighten, causing your toe to become permanently stiff.
If the toes remain in the hammertoe position for long periods, the tendons on the top of the foot will tighten over time because they are not stretched to their full length. Eventually, the tendons
shorten enough that the toe stays bent, even when shoes are not being worn. The symptoms of hammertoe include a curling toe, pain or discomfort in the toes and ball of the foot or the front of the
leg, especially when toes are stretched downward, thickening of the skin above or below the affected toe with the formation of corns or calluses, difficulty finding shoes that fit well. In its early
stages, hammertoe is not obvious. Frequently, hammertoe does not cause any symptoms except for the claw-like toe shape.
First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a
metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in
the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.
Non Surgical Treatment
Non-surgical methods for hammer toes (claw toes) are aimed at decreasing symptoms (i.e., pain and/or calluses) and/or limiting the progression into a larger problem. Simple treatments patients can do
are wear supportive shoes. Use an arch support. Wear shoes with a wide toe box. Modify activities. Spot stretch shoes. Periodic callus care.
Sometimes when the joints are removed the two bones become one as they are fused in a straightened position. Many times one toe will be longer than another and a piece of bone is removed to bring the
toes in a more normal length in relation to each other. Sometimes tendons will be lengthened, or soft tissue around the joints will be cut or rebalanced to fix the deformity. Angular corrections may
also be Hammer toe
needed. The surgeon may place fixation in your foot as it heals which may include
a pin, or wires.
The key to prevention is to wear shoes that fit you properly and provide plenty of room for your toes. Here?s how to get the right fit. Have your feet properly measured. The best way to do this is to
get someone to draw the outline of your foot while you stand barefoot with your full weight on it, then measure the outline at the widest point. Measure the soles of your shoes. Ideally, they should
be as wide as your feet, but certainly no more than half an inch narrower. Length matters, too, of course: your shoes should be half an inch longer than your longest toe.