Hammertoes

Toe deformities come in different forms. One most people are rather familiar with is a bunion – a condition wherein the big toe starts angling inward (which pushes its base joint out to the side). Hammertoe is another potential toe deformity – albeit, one that is quite different in appearance and root cause than a bunion.

Let’s take a look at this particular condition and why it develops, what kinds of symptoms you might experience, and how to fix hammertoe (both with surgical and nonsurgical treatment). If this is a problem you are experiencing, contact our team at Wilks Advanced Foot Care so we can get started on your customized hammertoe treatment plan!

What Does Hammertoe Look Like?

The first step in being able to address virtually any problem is to be aware one exists. In the case of hammertoe, you may recognize visual cues before you start to experience anything related to physical sensation or pain.

In fact, catching this problem early increases the likelihood we may be able to provide effective hammertoe treatment without surgery (but more on this in a little while).

With regards to hammertoe symptoms, the most obvious sign is a toe featuring an abnormal downwards bend at the middle joint – which ultimately can cause the front of the toe to point toward the floor. As a result, the toe has an appearance that is rather hammerlike. In most cases, the affected toe is the second one, but this is not always the case.

There are actually two conditions quite similar to hammertoes, yet have some different characteristics:

• Mallet toes. Between the two, this is more like hammertoe than the other. Similar to hammertoe, a mallet toe will most likely affect your second toe. It is different, however, in the location of the abnormal bend. Instead of being at the middle joint, the bending happens at the one closest to the tip of your toe. A mallet usually has a smaller head than a hammer, and this condition more closely resembles that particular tool.
• Claw toes. As with hammertoe, this is a toe deformity featuring abnormal bending. Unlike hammertoe, however, bending happens in all three of the toe joints. Claw toes bend upward at the metatarsophalangeal (MTP) joints—where the toes connect to the foot—and then downward in both of the other two joints. This bending pattern leaves the toes with a claw-like appearance (thus the name). One more key distinction is the fact that claw toes will often happen to all four of the smaller toes at the same time – instead of typically affecting only a single toe.

Generally speaking, these issues are all a matter of muscular or tendon imbalance. Toes have muscles and tendons on both the tops and bottoms of them that, when balanced, provide an equal tension and keep them flat. If one of these muscles or tendons becomes weakened, the balance is thrown off and a deformity can develop.

More specific causes of hammertoes and related conditions include poor-fitting footwear, arthritis, stroke, and traumatic injuries. Shoes become an issue when they are too tight and/or small and crowd toes together. This is especially the case with high heels, since there is also additional pressure on the toes and the front of the foot. When arthritis, stroke, or an injury affects the nerves or muscles in your feet and toes, the resulting muscular imbalance can cause a toe deformity like hammertoe to develop.

Treating Hammertoe – Conservative Care and Surgical Intervention

Depending on the severity and progression of the condition, we might be able to provide hammertoe treatment without surgery. This is more likely to be possible when the problem is caught early. Some nonsurgical care options we may include in our treatment plan include:

• Change in footwear – Making a switch from poor-fitting shoes—especially when the shoes are excessively tight—to pairs that fit correctly can help provide relief.
• Toe pads, insoles, custom orthotic devices – These options go inside footwear and provide additional cushioning (for greater comfort) and/or can help to redistribute forces on the affected foot.
• Medication – For some patients, we prescribe medication to relieve painful symptoms.
• Stretches – A stretching regimen can help to relieve pain for mild hammertoe cases. When we recommend this as part of your treatment, we will make sure that you know what types of stretches to perform for optimal relief.

Once a toe deformity has been present for some time, it becomes rigid and conservative methods tend to no longer be quite as effective. When we cannot provide the pain relief you need or reposition the toe, it becomes time to discuss surgery as an option.

In the event hammertoe surgery constitutes the best opportunity to provide you with relief, the goal will be to straighten the affected toes. Your case will dictate the specific procedures used, but we might need to either remove pieces of bone and/or release tendons responsible for the problem. Naturally, we will discuss this together and you will have the opportunity to ask any questions.

For any questions—or to request your appointment with our Roseburg office—contact us online or give Wilks Advanced Foot Care a call at (541) 673-0742.