What Are Hammertoes?

A hammertoe is one of those medical conditions that pretty much looks the way it sounds. When you have a hammertoe, one of your toes bends at its middle joint causing the end of your toe to stick out, kind of like the head of a hammer. Hammertoes happen when something puts pressure on your toes and pushes them out of place. Over time, muscles and tendons in your toes tighten, freezing your toes in a curled shape. A podiatrist will suggest at-home treatments to straighten your toes. Only severe cases require surgery.

A mild hammertoe may not affect your ability to walk or use your foot, but if it’s not treated, it can get bad enough to freeze your toe in its curled shape. Severe cases can make your toes look like they’re stuck in an upside-down V shape. Some people think affected toes have a hammer shape which is where hammertoes get their name.

Types of hammertoes

Podiatrists group hammertoes into three different types based on their severity:

1. Flexible hammertoes: You can still bend and move your affected toes but a noticeable curl or hammertoe is starting to form.
2. Semi-rigid hammertoes: Your affected toes are noticeably stiff or hard to uncurl.
3. Rigid hammertoes: The most advanced hammertoes are frozen in the curled position. You won’t be able to uncurl your toes at all. Rigid hammertoes are more likely to require surgery.

What causes hammertoes?

Most people experience hammertoes because they have an imbalance in their muscles and tendons. The imbalance causes the toe or toes to pull under, eventually causing a permanent change in the foot if not treated. Initially, hammertoes are flexible but become immobile as they worsen. In other words, if left untreated, the toes will cease normal movement.

Hammertoes happen when something pushes your toes out of position for a long time. Eventually, the muscles and tendons in your feet and toes adjust to the unusual, cramped position and tighten up. If that extra pressure lasts long enough, your muscles and tendons may tighten so much you can’t move your toes out of the curled position.

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The main causes of hammertoes include:

1. Wearing poorly-fitting shoes: Shoes that are too narrow or don’t have enough arch support can force your toes into unnatural positions. People who wear high heels and kids who keep wearing shoes they’ve outgrown may develop hammertoes.
2. Having high arch feet or flat feet: Your foot’s natural shape may make you more likely to develop hammertoes.
3. Having long toes: If your toes are naturally longer than usual, they may not have enough room in common shoe widths or sizes. This can put extra pressure on them and cause hammertoes.
4. Certain health conditions: Any condition that affects your feet and toes can cause hammertoes. People with diabetes or rheumatoid arthritis may have an increased risk.
5. Bunions: Bunions can push your toes out of alignment and put extra pressure on them.
6. Genetics: As with many health issues, sometimes you’re dealt an unlucky genetic hand. People with flat feet are more likely to get hammertoes due to how the toes curl to balance their gait. Feet with high arches are also at risk of hammertoes from imbalanced strain on the tendons.

Symptoms of Hammertoes

There are a variety of symptoms associated with hammertoes. The most common are:

1. Pain in the affected toes when wearing shoes, especially shoes with a narrow toe box.
2. Corns or calluses.
3. A burning sensation or inflammation.
4. Toes that contract or turn down.

When hammertoe is severe, the patient may suffer with open sores. These can be uncomfortable and lead to further complications such as infection.

What are hammertoe treatments?

Your podiatrist will suggest treatments to relieve the pressure on your affected toes and give them room to return to their natural position, including:

1. Footwear changes: Switching to shoes with wide, deep toe boxes can take pressure off your toes. You may be able to use a stretching device to widen shoes you already own.
2. Pads and taping: Over-the-counter (OTC) toe pads cushion the area around your toes to relieve pressure. Your provider might suggest using medical tape to hold your toes in the correct position.
3. Orthotic devices: Orthotics are shoe inserts that support your feet and keep your toes in the correct position. 
4. Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain and swelling. Don’t take NSAIDs for more than 10 days in a row without talking to your provider.
5. Toe exercises: Your podiatrist may suggest exercises or stretches that will help your toes stay in the correct alignment.
6. Surgery: Your podiatrist will usually only recommend surgery if other treatments don’t relieve your symptoms or walking is extremely painful. Your provider or surgeon will tell you which type of surgery you’ll need and what to expect.

How to Prevent Hammertoe

If you think you may be at high risk of developing hammertoe, you can do a few things to prevent it from developing. Fortunately, you can use simple methods to prevent hammertoe, such as wearing the proper footwear. Here are a few tips on how to prevent a hammertoe from developing:

1. Opt for comfort when choosing shoes and avoid wearing narrow or poor-fitting shoes.
2. Put down the high heels. High heels are notorious for bending the toes and forcing the feet into unnatural positions. Instead, opt for shoes with wide toe boxes and at least 1/2 an inch distance between each toe’s end and the shoe’s inside tip.
3. Choose shoes with adjustable laces and straps.
4. Use a shoe insert to align your toes correctly inside your shoes.
5. Do regular foot exercises that strengthen and stretch your toe muscles.
6. Purchase over-the-counter corn pads to relieve pressure on your toes from the top of your shoes.

When to Contact a Medical Professional

If you have hammer toe, contact your provider:

1. If you develop thick blisters or corns on your toes
2. If you develop sores over your toes that becomes red and swollen
3. If your pain gets worse
4. If you have difficulty walking or fitting into shoes comfortably

To schedule a consultation with a best podiatrist, contact our office today and set an appointment online. You may reach us in Bethesda Maryland to schedule an appointment. 

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