Hammertoes are a type of crooked toe that involve unnatural contracture, or bending, of your toes. In most cases, a hammertoe is characterized by a toe malposition in which the end of your affected toe points down and the first joint of your same toe—your proximal interphalangeal joint—points up. This crooked toe syndrome usually leads to rubbing within your shoe and pain. A hammertoe resembles an upside-down letter v when viewed from the side. This crooked toe syndrome most commonly affects your second to fifth toes, though it may also affect your big toe. This health problem is more commonly experienced by women than men.
People 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.
Hammertoes can be flexible or rigid. Hammertoes often start out flexible and become rigid over time as your toe becomes accustomed to its crooked position. Flexible hammertoes are less serious than rigid hammertoes, as they can be easily diagnosed and treated in their initial stages. Flexible hammertoes are named as such because your affected toe still possesses some degree of movement.
Rigid hammertoes are toes that do not move when you try to bend them. Rigid hammertoes are particularly common in people who have advanced arthritis or among people who avoid appropriate care for a prolonged period. Tendons in your rigid hammertoe have become tight, and your joints may be misaligned and immobile. Rigid hammertoes may require surgery to help correct if more conservative strategies fail to resolve your problem.
Causes and Symptoms
Footwear can contribute significantly to the development of hammertoes. Shoes that are too small force your toes into a curled position. Over time, your toe tendons adjust to this positioning, causing your toe or toes to hold a hammered shape. Athletes may be especially susceptible, because of the increased forces on the toes from shoes that are too small or tight. Heel elevation in footwear is also problematic, as it causes your toes to be pushed into the shoe’s toe box. Heel elevation additionally contributes to muscle imbalance. A common example of this is when your Achilles tendon—the tendon at the back of your leg that attaches your calf muscles to your heel bone—is too tight, causing the tendons on the top of your foot that attach to your toes to work too hard and hold your toes in an unnatural, elevated position.
Pain on the bottom of your foot, especially under the ball of your foot, is one of the most common symptoms associated with hammertoes. Other common signs and symptoms of hammertoes include:
• Pain at the top of your bent toe from footwear pressure
• Corns on the top of your bent toe
• Redness and swelling in your affected area
• Decreased joint range of motion in your affected toe joints
Your podiatrist may recommend conservative treatment techniques for your hammertoes based on your foot structure, which will likely involve removing any thick, painful skin, padding your painful area, and recommending for you shoes that give your curled toes adequate room. Conservative care strategies for this health purpose may also involve the use of Correct Toes, our toe straightening and toe spacing device.
Your podiatrist may recommend a surgical procedure if your hammertoes are not helped by the conservative care methods listed above. Surgery for hammertoes is performed to help straighten your crooked toe. Your surgery will be performed in your podiatrist’s office or at a hospital, depending on the severity of your hammertoe. A metal pin is sometimes used to help your affected toe maintain its straight position during your recovery.
In his 18 years as a podiatrist, Dr. Ray McClanahan has learned that most foot problems can be corr...