is a deformity of the second, third or fourth toes in which the
main toe joint is bent upward like a claw. Initially, hammertoes are flexible and can be corrected with simple measures. Left untreated, they can become fixed and require surgery. Hammertoe results
from shoes that don?t fit properly or a muscle imbalance, usually in combination with one or more other factors. Muscles work in pairs to straighten and bend the toes. If the toe is bent and held in
one position long enough, the muscles tighten and can?t stretch out.
If a foot is flat (pes planus, pronated), the flexor muscles on the bottom of the foot can overpower the others because a flatfoot is longer than a foot with a normal arch. When the foot flattens and
lengthens, greater than normal tension is exerted on the flexor muscles in the toes. The toes are not strong enough to resist this tension and they may be overpowered, resulting in a contracture of
the toe, or a bending down of the toe at the first toe joint (the proximal interphalangeal joint) which results in a hammertoe. If a foot has a high arch (pes cavus, supinated), the extensor muscles
on the top of the foot can overpower the muscles on the bottom of the foot because the high arch weakens the flexor muscles. This allows the extensor muscles to exert greater than normal tension on
the toes. The toes are not strong enough to resist this tension and they may be overpowered, resulting in a contracture of the toe, or a bending down of the toe at the first toe joint (the proximal
interphalangeal joint) which results in a hammertoe.
Pain upon pressure at the top of the bent toe from footwear. The formation of corns on the top of the joint. Redness and swelling at the joint contracture. Restricted or painful motion of the toe
joint. Pain in the ball of the foot at the base of the affected toe.
Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination,
the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the
degree of the deformities and assess any changes that may have occurred.
Non Surgical Treatment
Wearing proper footwear may ease your foot pain. Low-heeled shoes with a deep toe box and flexible material covering the toes may help. Make sure there's a half-inch of space between your longest toe
and the inside tip of your shoe. Allowing adequate space for your toes will help relieve pressure and pain. Avoid over-the-counter corn-removal products, many of which contain acid that can cause
severe skin irritation. It's also risky to try shaving or cutting an unsightly corn off your toe. Foot wounds can easily get infected, and foot infections are often difficult to treat, especially if
you have diabetes or poor circulation.
If these non-invasive treatments don?t work, or if the joint is rigid, a doctor?s only recourse may be to perform surgery. During the surgery, the doctor makes an incision and cuts the tendon to
release it or moves the tendon away from or around the joint. Sometimes part of the joint needs to be removed Hammer toes
or the joint
needs to be fused. Each surgery is different in terms of what is needed to treat the hammertoe. Normally after any foot surgery, patients use a surgical shoe for four to six weeks, but often the
recovery from hammertoe surgery is more rapid than that. An unfortunate reality is that hammertoe can actually return even after surgery if a patient continues to make choices that will aggravate the
situation. Though doctors usually explain pretty clearly what needs to be done to avoid this.
The best first step you can take is to evaluate your shoe choices. Ditch any shoes that aren?t serving your feet well. Shoes that crowd the front of your foot, especially around your toes, aggravate
the existing condition and can also cause the condition to develop. If you suspect the development of hammertoe, you may also try using protective pads to prevent irritation and the development of
corns. Custom orthotics to correct muscle imbalances in your feet may also help prevent hammertoe.