The term, Hammer toes
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.
Hammertoes are a contracture hammertoes
of the toes as a result of a muscle imbalance between the
tendons on the top of the toes (extensor tendons) and the tendons on the bottom of the toes (flexor tendons). If there is an imbalance in the foot muscles that stabilize the toe, the smaller muscles
can be overpowered by the larger flexor and extensor muscles.
The most obvious symptoms of this injury will be the the middle toe joint is permanently bent at an angle. In the beginning movement may still be possible but as time passes and the injury worsens
the toe will be locked in place and possible require hammer toe correction surgery to fix. Another key indicator of hammer toe is that a lump or corn will form on top of the toe. The toe joint will
be painful and walking can cause severe discomfort. Occasionally a callus may form on the sole of the injured foot. If you see any of these symptoms together or have been enduring pain for some time,
seeing a podiatrist should be your next step.
Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some
types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe. If the deformed toe is very painful, your doctor may recommend that you have a fluid sample withdrawn
from the joint with a needle so the fluid can be checked for signs of infection or gout (arthritis from crystal deposits).
Non Surgical Treatment
In many cases, conservative treatment consisting of physical therapy and new shoes with soft, spacious toe boxes is enough to resolve the condition, while in more severe or longstanding cases
podiatric surgery may be necessary to correct the deformity. The patient's doctor may also prescribe some toe exercises that can be done at home to stretch and strengthen the muscles. For example,
the individual can gently stretch the toes manually, or use the toes to pick things up off the floor. While watching television or reading, one can put a towel flat under the feet and use the toes to
crumple it. The doctor can also prescribe a brace that pushes down on the toes to force them to stretch out their muscles.
If you have a severe case of hammer toe or if the affected toe is no longer flexible, you may need surgery to straighten your toe joint. Surgery requires only a local anesthetic (numbing medicine for
the affected area) and is usually an outpatient procedure. This means you don?t have to stay in the hospital for the surgery.
If you notice the beginning signs of hammertoe, you may be able to prevent the tendons from tightening by wearing toe-friendly shoes, by flattening your toes regularly, and by soaking your feet every
day in warm water, then stretching your toes and ankles by pointing your toes. Foot exercises also can help to maintain or restore the flexibility of the tendons. One simple exercise is to place a
small towel on the floor and then pick it up using only your toes. You also can grasp at carpet with your toes or curl your toes up and down repeatedly.