Understanding Hammertoes
Hammertoes occur when one or more toes bend abnormally at the middle joint, often due to imbalances in the muscles, tendons, or ligaments that keep the toe straight. This condition can cause discomfort, rubbing, and difficulty fitting into shoes. Over time, the deformity may progress from flexible to rigid, making treatment more challenging. With early attention and proper care, many people can reduce symptoms and maintain comfortable mobility.
How Hammertoes Develop
Hammertoes form when the structures that control toe movement become imbalanced, causing the toe to curl downward at the middle joint. This deformity most often affects the second, third, or fourth toes, while the big toe is less commonly involved. Shoes that are too tight or too small contribute significantly, as they force the toes into a cramped position and prevent normal alignment. Prolonged standing and wearing high-heeled shoes also increase the risk, especially for individuals with naturally longer second toes or preexisting foot issues.
Trauma can also lead to hammertoes. A stubbed or fractured toe may heal in a curled position, or structural differences in the tendons and ligaments may cause the toe to bend. Conditions such as arthritis, diabetes, or impaired circulation can weaken the tissues supporting the toe, making the deformity more likely. In some cases, hammertoes run in families and develop due to inherited foot structure.
Recognizing the Symptoms
The most noticeable symptom of hammertoe is the bent position of the affected toe, which may be difficult or painful to straighten. Shoes may rub against the bent joint, causing corns, calluses, or irritation on the top or sides of the toe. Toenails may become damaged from repeated friction with footwear. As the condition progresses, movement may become increasingly limited.
Ongoing pressure and rubbing can create sores or skin breakdown on the toe, especially in individuals with diabetes who may be more prone to infections. Moist conditions inside shoes can contribute to ulcers, making prompt evaluation important. Pain during walking or standing is common as the toe becomes more rigid and less able to function normally.
Treatment and Management Options
When hammertoes are still flexible, conservative care is often effective. Changing to properly fitting shoes, using orthotics, or adding cushioned pads can relieve pressure on the affected toe. These measures help reduce pain and prevent further irritation. Strengthening and stretching exercises, such as picking up marbles with the toes, can improve muscle balance and support healthier alignment. If symptoms persist, the orthopedic team may recommend additional therapies to reduce inflammation and improve comfort.
Long-Term Care and Surgical Options
If conservative treatments do not improve symptoms or if the hammertoe has become rigid, surgery may be recommended. Surgical procedures may involve releasing tight tendons, repositioning the joint, or removing small pieces of bone to allow the toe to lie flat again. Recovery time varies depending on the procedure, but most patients benefit from improved comfort and easier mobility afterward.
To prevent recurrence, choosing supportive footwear and avoiding narrow or high-heeled shoes is essential. Regular stretching and strengthening exercises can also help maintain proper toe alignment. With appropriate treatment and ongoing care, individuals with hammertoes can achieve lasting relief and return to daily activities more comfortably.