How Hammertoes Form and What to Do about Them

 

We all prefer things to work and look the way they are supposed to, but sometimes that is not the case. When you look at your feet, do you notice that some toes seem out of position? Instead of lying flat and straight, are they bent at a right angle like a hammer? When the middle joint of the second, third, or fourth toe pokes up into the air farther than normal, you may have a condition called hammertoes.

Why Won’t My Toes Straighten Out?

The position of your toes is determined by the muscles attached to them. Muscles can only pull, not push, so you need some of them to curl the toe up, and others to pull it straight again. When these two sets of muscles are not in balance, your toe stays in a curled-up position. Why would this happen? One cause is shoes that force the toes into a bent position, which is why women experience this condition more often than men.

Shoes with pointed toes don’t have enough room for your toes to lie flat and high heels push them against the front of the shoe. In both cases, your toes are held in a deformed shape. The middle joint bends up like an upside-down V, while more weight is put on the tip and the base where they press against the shoe. The muscles under your toe become tighter and shorter while those on top loosen and lengthen. Over time, the bottom muscles can’t stretch out, and the top muscles are no longer strong enough to pull your toe flat, even when you aren’t wearing shoes.

Another consequence is the formation of a corn at the top of the V where your toe joint constantly rubs against the shoe. This small, circular patch of hard, dry skin can become quite painful as your shoe presses it into the tender tissue below it. Calluses can also develop on the tip of your toe and ball of your foot, from the extra pressure of your weight on those spots.

Early Treatment of Flexible Hammertoes

First of all, you need to choose footwear for function and comfort first—and style second. Ladies sometimes have trouble with this, but it is necessary if you don’t want to hobble around with painful, bent toes. Shoes should be a half-inch longer than your longest toe, and have enough width to let your toes move around. Heels should be low enough to distribute your weight evenly over your foot, instead of forcing it all onto the ball of foot area. The shoe material should have some give to it, such as soft leather or canvas, or you might be able to have your stiff pair stretched out at a shoe repair shop. Sandals may be a helpful style, as long as they provide sufficient support for your arch. To view a sampling of some of the shoes we recommend, visit the Country Foot Care Medical Shoe Store.  

As hammertoes are caused by the unequal pulling of tendons when you walk, correcting the underlying biomechanical imbalance by wearing the right shoes and custom orthotics can relieve pain and help avoid surgery by arresting the progression of the deformity.  There are also simple steps you take on your own to deal with this problem.  If your toe is bent (hammered) but still flexible, try stretching it by gently pulling it toward you, or pick up small items from the floor with your toes to strengthen the muscle function. You can also sit with your feet on the floor and scrunch up a towel with your toes. Other treatment methods include cushions or padding from the drug store to protect tender areas, or taping to hold the bent toe straight.

 

How to Treat Rigid Hammertoes

Don’t wait to see us only after your toe has become rigid and you can’t flatten it at all—even by pressing down on it. At that point, conservative methods will not work and we may have no option but to recommend surgical treatment to straighten it. At this point, conservative treatment consisting of pairing down the corns and calluses will only afford temporary pain relief.  Because hammertoe deformities are progressive, patients can reach a point where conservative treatment will not work, and surgery may be considered to straighten the toe.  Patients with poor circulation due to diabetes may only have non-surgical options available to them due to the risks associated the disease.  These options would include wearing shoes designed for the challenges of diabetes, available in our Medical Shoe Store, and having care performed by one of the Country Foot Care doctors.

Our goal is to help you reach the optimal level of foot health care.  To learn how we can help you we invite you to make an appointment by contacting our offices during regular hours or, to schedule an appointment online now, simply click on the REQUEST AN APPOINTMENT button at the top of this page.