is a Z-shaped deformity caused by dorsal subluxation at the
metatarsophalangeal joint. Diagnosis is clinical. Treatment is modification of footwear and/or orthotics. The usual cause is misalignment of the joint surfaces due Hammer toe
to a genetic predisposition toward aberrant foot biomechanics and
tendon contractures. RA and neurologic disorders such as Charcot-Marie-Tooth disease are other causes.
Hammer toes result from a muscle imbalance which causes the ligaments and tendons to become unnaturally tight. This results in the joint curling downward. Arthritis can also lead to many different
forefoot deformities, including hammer toes.
The symptoms of a hammer toe are usually first noticed when a corn develops on the top of the toe and becomes painful, usually when wearing tight shoes. There may be a bursa under the corn or instead
of a corn, depending on the pressure. Most of the symptoms are due to pressure from footwear on the toe. There may be a callus under the metatarsal head at the base of the toe. Initially a hammer toe
is usually flexible, but when longstanding it becomes more rigid.
Hammer toes may be easily detected through observation. The malformation of the person's toes begin as mild distortions, yet may worsen over time - especially if the factors causing the hammer toes
are not eased or removed. If the condition is paid attention to early enough, the person's toes may not be permanently damaged and may be treated without having to receive surgical intervention. If
the person's toes remain untreated for too long, however the muscles within the toes might stiffen even more and will require invasive procedures to correct the deformity.
Non Surgical Treatment
In the early stages, the deformities from mallet toe, claw toe and hammertoe can be corrected. But if treatment is delayed too long, permanent stiffness can ensue which can only be corrected by
surgery. The most effective treatment options are good fitting footwear. Shoes with a wide toebox will be more comfortable and will reduce the tension on the muscles and friction on the toes. Avoid
high heels as they push your feet forwards to the front of the shoes. This increases the pressure on the toes, forcing them to bend more than usual. Shoes should ideally be half an inch longer than
your longest toe. Exercises to strengthen and stretch the muscles can be really helpful. Simple things like trying to pick marbles up with your feet or scrunching up a towel underneath your foot can
Surgery may be the treatment of choice if conservative approaches prove unsuccessful. Usually performed as an outpatient procedure, the specific surgery will depend on the type and extent of injury
to the toe. Recovery my take several days or weeks and you may experience some redness, stiffness and swelling of the affected toe. Your physician will recommend taking it easy and to keep your foot
elevated while you recover.
Walking barefoot increases the risk for injury and infection. Being on your feet throughout the day can cause them to swell, this is the best time to buy shoes to get a better fit. Do not buy shoes
that feel tight. Do not buy shoes that ride up and down your heel as you walk. The ball of your foot should fit into the widest part of the shoe. Remember, the higher the heel the less safe the shoe
will be. Avoid shoes with pointed or narrow toes. If the shoes hurt, do not wear them. If you start noticing the beginning signs of hammer toes, you may still be able to prevent the tendons from
tightening by soaking your feet every day in warm water, wearing toe friendly shoes, and performing foot exercises such as stretching your toes and ankles. A simple exercise such as placing a small
towel on the floor and then picking it up using only your toes can help to restore the flexibility of tendons.