Toes are supposed to lie straight and flat. Unfortunately for millions of Americans, that is no longer the case.

A hammertoe refers to any of the smaller toes that do not lay straight while standing. The toe remains “stuck” in a bent position with the middle joint arched up and the tip of the toe pointed downward. This deformity is at best unsightly, and at worst painfully uncomfortable.

Hammertoes most commonly affect the second digit, but any of the four smaller toes on either foot may be affected. They often start out mild and flexible, but without treatment, hammertoes will worsen, becoming stiff and/or rigid. It is better to deal with this deformity in the early stages to avoid the pain and difficulty associated with late-stage hammertoes.

Why Is My Toe Bent?

In order to flex, curl, and straighten out, pairs of muscles, tendons, and ligaments attaching to and within the toe must work in tandem. If a strength imbalance develops between these tissues, your toe may no longer lie flat when you stand. The muscles responsible for simply keeping the toe straight are not strong enough to do the job on their own.

Why does this happen in the first place? In most cases, the underlying factors are genetic. In other words, you inherit a foot structure prone to developing hammertoes. For example, people whose second toes are longer than their large toes are especially vulnerable.

However, there are many external factors that can aggravate your hammertoes, which can make them more painful or likely to develop faster. They include:

 

  • Wearing ill-fitting shoes, whether they are too small, too loose, or not wide enough in the toe box.
  • Wearing shoes that put excess weight and pressure on the front portion of the foot, such as high heels.
  • A previous injury to the toe, such as stubbing or breaking it.
  • Capsulitis, an overuse injury in the ball of the foot, weakens and damages the ligaments that stabilize the base of the toe.

How Hammertoes Progress

As previously stated, an early-stage hammertoe seems quite mild and innocuous. The raised joint in the middle of the toe remains relatively flexible, easily extended and straightened when held in place with your fingers.

However, without treatment, the bent joint will slowly become more rigid and arthritic and will no longer depress even if you try to push and hold it down.  The stiff, contracted shape of the toe may develop blisters, corns, or ulcerations on the top of the bent knuckle or the tip of the toe where the pressure of the shoe rubs against them.

Severe hammertoes typically require surgery to correct, so it is best to seek professional help long before it gets to this point.

How Are Hammertoes Treated?

If your hammertoe still has a flexible joint, we will usually recommend you wear a hammertoe regulator or Crest pad. Both devices are a soft type of splint with a cushioned pad for the underside of your foot and toe with adjustable straps that keep your hammertoe in a straightened position.

These splints will not “fix” your hammertoe, just like a pair of glasses will not “fix” your eyes. However, early and consistent use of the hammertoe regulator or Crest pad can help keep your hammertoe from reaching the rigid, painful, arthritic stage. It will also protect your toe from painful shoe friction, thus preventing the formation of corns, blisters, and ulcerations.

Other recommended conservative strategies include roomier shoes, orthotics, pads, or toe exercises.

If your hammertoe becomes rigid and is causing pain or limiting your daily activities on a regular basis, surgery will likely be your best choice. Hammertoe surgery can be performed as an outpatient procedure, under IV sedation, allowing you to return home the same day. Recovery usually takes four weeks, although this depends on the severity of your hammertoe and the type of procedure selected. We will obviously go over all these details with you carefully at your appointment.

Do not let the pain of a hammertoe keep you from doing what you love. Regardless of whether your hammertoe is already arthritic, or is still very flexible, please call Dr. Thomas J. Bobrowski and the team at InStride Crystal Coast Podiatry today for a full exam and personalized treatment options.