Also known as “Mallet Toe” Hammer Toe is a type of foot deformity that is related to an imbalance in the muscles, tendons, or ligaments that normally hold a particular toe straight, in the proper position, or orientation. Hammertoe can be caused by things like the type of shoes you wear, your unique foot structure, past foot trauma, and even some disease processes that can affect the natural development of the foot in childhood.
A lot of cases of hammertoe manifest as an abnormal bend in the middle joint of a single toe. Though it doesn’t have to be limited to just one toe. In fact, many people with a hammer toe will have the deformity appear on multiple toes. Especially in cases where the primary cause was related to widespread foot trauma or frequently wearing poorly fitting shoes
Many cases of hammertoe affect the joint nearest to the toenail. Hammertoe also tends to be more common in the second, third, and fourth toes. It is relatively rare in the big toe, which has more firm structures and a flatter orientation than the rest of the toes.
Properly relieving the pain and pressure caused by hammertoe starts with changing your footwear and might also include wearing special shoe inserts. In a more severe case of hammertoe, you might need surgery to get sufficient pain relief and adjust the deformity of the toe.
What Are Common Symptoms of Hammertoe?
The most prevalent symptom of hammertoe is a pronounced abnormal bend in the joints of one or more of your toes. Most people will note that moving the affected toe is often difficult and oftentimes even painful.
Many people with hammertoe also end up developing corns and thick calluses on the toes. This is often the result of the toe excessively rubbing against the inside of your shoes. As time goes on these hardened areas of skin can become just as painful as the joint discomfort. More than one person has gone to see their physician about the callouses, only to be surprised by a hammertoe diagnosis!
Increased Risk Factors for Developing Hammertoe
There are a few increased risk factors that can make it more likely for you to develop hammertoe or mallet toe over time.
Uncomfortable or Improperly Fitting Shoes
If you frequently wear high-heeled shoes or footwear that is overly tight in the toe area it can start to crowd your toes into a space in which they can’t lie naturally flat. As time goes on this abnormal curled toe position might eventually persist even when you are barefoot.
Foot Trauma
A foot injury in which you stub, jam, or break a toe can make it more likely for that digit to develop hammertoe. These traumatic incidents can damage the connective tissues in the joints of the toe causing it to heal in an unnatural orientation. This is more likely to be a compounded effect if you also tend to wear high heels or tight-fitting shoes a lot.
An Imbalance in the Toe Muscles
Abnormalities in the toe muscles as well as the surrounding muscles of the foot can also put you at heightened risk for developing hammertoe. This imbalance leads to instability, which can cause the toe to contract.
Other Risk Factors For Hammertoe
There are other increased risk factors for developing hammertoe that includes:
- Age
- Being female
- Wearing high heels
- Having a long second or third toe
- Arthritis
- Diabetes
- How To Prevent Hammertoe
If you have risk factors for hammertoe, or you have noticed the early stages of deformation in one or more of your toes, there are a few things you can do to try to prevent it or at least keep the deformation from getting worse.
- Don’t wear shoes with pointed toes
- Don’t wear high heels
- Wear laced or strapped shoes
- Wear shoes that are roomier and adjustable.
How Is Hammertoe Diagnosed?
Your physician will start with evaluating your symptoms to ensure that there might not be any other foot conditions at play. Be sure to let them know if you have suffered trauma to the affected foot or toes. Let them know about any medical conditions you have that might affect your joint health. This includes things like rheumatoid arthritis, diabetes, gout, or chronic inflammatory conditions that affect your joints.
This will likely be followed up by a physical exam. Your physician might always want to take X-rays or refer you for an MRI to get a better understanding of the internal structures affecting the deformation of your toes. If necessary, they might refer you to a podiatrist or some other type of foot care specialist.
How Is Hammertoe Treated?
If it is caught early, lifestyle changes and changes in your footwear might be all that’s needed to gradually correct a mild case of hammertoe or mallet toe. If you have more than one toe with a deformation, or you’ve let the hammertoe problem go unaddressed for a long time, your physician might recommend fitting you for a special orthotic foot brace.
This will be custom molded to your foot and you might need to switch out to a slightly different orthotic over time. This will gradually shift the toe into its more natural orientation without the need for surgical intervention. This is the preferred course for treating hammertoe. Your physician might also need to treat any callouses or corns to help your foot orthotic fit comfortably.
Surgery for Hammertoe
There are two different surgical options to treat a severe case of hammertoe or a case where non-surgical intervention has failed to bring the necessary relief.
Joint Resection Surgery for Hammertoe
A joint resection procedure for treating an advanced case of hammertoes starts with a surgeon making an incision on the top part of the toe to reach the ligaments and tendons underneath.
At that point, the affected ligaments and tendons might need to be cut to relieve tension enough to effectively straighten the toe.
Then a small amount of tissue is carefully removed from the end of one bone so that the toe can be fully extended. Small metal pins or rods are often used to keep the toe straight during healing. The pins are will need to be removed after a month or so after surgery.
Surgical Fusion for Treating Hammertoe
Fusion surgery for hammertoes also involves the surgeon cutting, ligaments, and tendons. Though with this technique the ends of the two bones that form the affected joint are bisected to make the toe straight.
Then pins and/or screws are inserted into the ends of the bone heal to hold in in place while they fuse together. Recovery from fusion surgery typically takes longer and might require up to 5 to 8 weeks.