Hammertoe is a common foot deformity characterized by toes that curl or bend at the middle joint, sticking in an upward position and overlapping neighboring toes. The condition typically affects the second, third, or fourth toes, and can cause pain and difficulty walking that can progressively worsen without treatment.
Fortunately, proper preventative measures and prompt treatment for issues that arise can help stop these painful and unsightly deformities in their tracks. Here's what you should know about hammertoes, including how our adept Grandville podiatrist can help keep your feet and toes looking and feeling their best.
Types of Hammertoes
There are three main types of hammertoe deformities, categorized by the rigidity of the middle toe joint:
- Flexible hammertoes are those diagnosed in the developmental stage, while the middle joint is still movable.
- Semi-rigid hammertoes are a moderate form of the deformity in which the middle joint(s) of the affected toe(s) are beginning to stiffen and lose range of motion.
- Rigid hammertoes are stuck in place and can no longer move at the middle joint due to the stiffening and tightening of the tendons and soft tissues.
Generally speaking, the more rigid the middle toe joint, the greater the potential for pain and other complications.
How Hammertoes Differ From Mallet Toes and Claw Toes
While similar, the hammertoes, claw toes, and mallet toes aren't interchangeable. The differences depend on which joints of the toe are bent.
- In hammertoes, the bend is in the second—or middle—toe joint.
- In claw toes, the first and second toe joints are bent.
- In mallet toes, the bend is in the third toe joint, the one nearest the nail.
Hammertoe Symptoms and Potential Complications
In addition to their characteristic stiffness, upward positioning, and joint pain, hammertoe deformities can cause the affected toes to rub against the inside of shoes, resulting in calluses, corns, or blisters. If lesions like these aren't given the chance to heal, they can become infected or lead to a skin ulcer, both of which can be particularly dangerous for people with underlying health conditions like diabetes or poor circulation.
Causes, Risk Factors, and Prevention
Hammertoes develop due to an imbalance of muscles and ligaments. As muscles in the affected foot or leg weaken, they can cause the tendons to your toe to pull abnormally, resulting in a contracture that resembles a hammer. These deformities can be caused by:
- Genes. You may have inherited foot conditions or structural features like high arches that make you more prone to developing hammertoes.
- Trauma. Injuries to toe muscles, ligaments, or tendons can create the kind of imbalance that leads to these types of deformities.
- Wearing the wrong shoes. Footwear that is too small, too tight, high heeled, or has a narrow, pointed toe box can crowd your toes, leading to pressure that can result in hammertoes.
- Neuromuscular disorders. Conditions that can damage nerves in the lower extremities, such as Charcot Marie Tooth disease (CMT) and Friedreich's ataxia can contribute to hammertoe development.
- Arthritis. This condition can upset the balance of muscles and ligaments around the middle joints of affected toes, enabling hammertoe deformities.
Your risk of developing hammertoes can increase with age. Additionally, you may be more prone to them if you are a woman; struggle with alcoholism; or have bunions, long toe bones (where the second toe is longer than the first), or feet that rotate inward as you walk.
While you can't change your genes, making a few simple lifestyle changes may be able to help you avoid this painful podiatric problem.
- Opt for well-made, supportive shoes with plenty of room in the toe box, rather than narrow, pointy shoes that compress the toes and restrict their movement.
- See a podiatrist to find out if you can benefit from custom orthotics, which may provide the personalized support needed to prevent imbalances that can lead to hammertoes.
- Schedule regular visits with a podiatrist who can diagnose and treat conditions that could contribute to the development of these deformities.
Hammertoe Treatment Options
The earlier you seek treatment for a stiffening middle toe joint, the more treatment options are available. Conservative hammertoe treatments include wearing supportive, properly fitted shoes; stretching and strengthening exercises; padding and taping; anti-inflammatory medications; cortisone shots; and the use of straps, cushions, corn pads, or custom inserts. Stop in to our store to browse the padding products we offer and purchase the best option for you.
However, if conservative treatments fail, surgery may be required to reposition the affected toe(s). Surgical options include:
- Arthroplasty, which involves removing half of the joint under the hammertoe, enabling it to lie flat
- Arthrodesis, in which the entire joint under the deformed toe is removed and a wire inserted to help it straighten during the healing process
- Tendon transfer, which attaches tendons on the underside of the toe to its top to aid in straightening
- Basal phalangectomy, which involves removing the base of the bone under the affected toe
- Weil osteotomy, in which certain bones are shortened and have screws inserted
Providing the Highest Standard of Podiatry Care
Experiencing stiffness in the middle joint of any of your three middle toes? Consulting a skilled podiatrist as soon as possible can help prevent the condition from becoming more serious. Fortunately, you've come to the right place.
At Grandville Foot and Ankle, our podiatry team provides the highest standard of care available. Podiatrist Dr. Sarah Stewart is committed to helping you resolve hammertoes or other conditions so that you can get back on your feet and back to your favorite activities. You can count on her to listen to your concerns, answer your questions, and work with you to create a personalized treatment plan to help you reach your goals.
Schedule an Appointment
Complete our contact form or call us at 616-534-3920 to schedule an appointment with Dr. Stewart. Don't wait—the first step to better foot health is just a call or click away.