The name Hammer toes
comes from the way the tip of the toe hits or hammers on the floor with each step.
The primary deformity seen in a hammer toe is found at the PIPJ (proximal interphalangeal joint) which is the first or more proximal of the two joints of the toe. A mallet toe, on the other hand, is
a similar deformity but is found in the DIPJ (distal interphalangeal joint). And lastly, claw toes are a deformity where the entire toe grabs and involves the MPJ (metatarsal phalangeal joint) PIPJ
and DIPJ. Collectively, these deformities are referred to as hammer toes. Hammer toes can affect one or all of the toes simultaneously.
The APMA says that hammertoe can result from a muscle imbalance in the foot that puts undue pressure on the joints, ultimately causing deformity. Inherited factors can contribute to the likelihood of
developing hammertoe. Arthritis, stroke or nerve damage from diabetes or toe injuries such as jamming or breaking a toe can affect muscle balance in the foot, leading to hammertoe. The Mayo Clinic
says that wearing improper shoes often causes hammertoe. Shoes that squeeze the toes, such as those with a tight toe box or with heels higher than two inches, can put too much pressure on the toe
Symptoms include sharp pain in the middle of the toe and difficulty straightening the toe. People with hammertoe may also develop blisters, which are fluid-filled pockets of skin, because the bent
toe is likely to rub against the inside of a shoe. This increased friction may also lead to calluses, which are areas of thickened skin, and corns, which are hard lumps that may form on or between
toes. Symptoms may be minor at first, but they can worsen over time.
Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some
types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe. If the deformed toe is very painful, your doctor may recommend that you have a fluid sample withdrawn
from the joint with a needle so the fluid can be checked for signs of infection or gout (arthritis from crystal deposits).
Non Surgical Treatment
If your toe is still flexible, your doctor may recommend that you change to roomier and more comfortable footwear and that you wear shoe inserts (orthotics) or pads. Wearing inserts or pads can
reposition your toe and relieve pressure and pain. In addition, your doctor may suggest exercises to stretch and strengthen your toe muscles. These may include picking up marbles or a thin towel off
the floor with your toes.
Surgery to correct for a hammertoe may be performed as an outpatient procedure at a hospital, surgery Hammer toe
center, or in the office of your podiatrist. There are multiple procedures that can be used depending on your individual foot structure and whether the deformity is flexible or rigid. There may be a
surgical cut in the bone to get rid of an exostosis, or a joint may be completely removed to allow the toe to lay straight.