Hammertoe – a common toe deformity

What is a hammertoe deformity?

Our smaller toes each have 3 bones and 2 joints that help them to bend and straighten. A hammertoe is a toe deformity where the middle joint of your toe, otherwise known as the proximal interphalangeal joint, bends (contracts) or curls downwards, instead of pointing straight. Due to this bend in the joint, the toe resembles a hammer shape from side on. Hammertoes can affect any toe on your foot, however the second or third toe are the most common toes to be affected.

A hammertoe can either be flexible or rigid. Flexible hammertoes are still moveable and can be straightened with applied pressure, these are less severe. However, rigid hammertoes cannot be straightened with force and often cause more problems.

What causes hammertoes?

A hammertoe can be present from birth but more often they develop over time. Footwear plays a significant role in the development of a hammertoe, although trauma and weak tendons are also common causes of toe deformity.

Hammertoes are caused by an imbalance in the muscles, tendons and ligaments surrounding a toe that usually work together to keep it straight. If that contracted position remains over time, these structures become rigid and permanently fixed in that position.

The following are factors that can lead to hammer toes developing:

Muscle or tendon changes: There are tendons in your toes that enable them to move. Over time, these muscles and tendons can be weakened and can result in the abnormal bending of the toe.

Tight or ill fitting footwear: One of the most common causes of a hammertoe is ill fitting or tight footwear. If your toes are forced into a tight pair of shoes this can cause changes to the toe.

Genetics: If you have a family history of hammertoes you are more likely to inherit one or the same foot shape. A longer second toe can also predispose you to a hammertoe. Women are also more likely to develop hammertoes.

Trauma: If you’ve previously had an injury in which you stub, jam or break a toe this can make it more likely for that digit to develop hammertoe.

Bunions: When the big toe is progressing towards the other toes the lesser digits often have to move out of the way. This can cause digital deformities, such as hammertoes, in any of these digits, as the structure of the forefoot is changing and they are required to adapt.

Other medical conditions: Conditions such as diabetes mellitus, arthritis and some neurological conditions can cause hammertoes to develop.

Symptoms of a hammertoe

The visual appearance of a hammertoe is the main symptom when diagnosing a hammertoe however the following are also common symptoms:

• Painful corns and calluses can form on the bent joint or the tip of the toe due to pressure
• Pain on top of the toe especially when wearing enclosed footwear
• Redness and swelling where the toe bends
• Restriction or pain when straightening the toe
• Calluses forming on the ball of the feet at the base of the affected toe

There are also other types of toe deformities such as mallet toes and clawed toes

Mallet toes – A bend through the end joint near the toenail, called the distal interphalangeal joint.

Clawed Toes – A bend through both the middle and end joints of the toe – the proximal and distal interphalangeal joints.

Treatment for hammertoes

Treatment for hammertoes is varied depending on the cause and severity of the toe deformity. If you have any pain or think you may be developing a hammertoe or any toe deformity you should see one of our Melbourne podiatrists for treatment. Hammertoes are progressive in nature and if left untreated they can become rigid and will require more extreme or complex treatment to correct.

At Melbourne Podiatrists and Orthotics our podiatrists will assess the hammertoe to rule out any underlying conditions or injuries such as plantar plate tears. Our podiatrists will conduct a thorough assessment and if needed refer for any further investigations.

Treatment is often about relieving the pain caused by the deformity and may include:

• Footwear changes: wider shoes with a deeper toe box will reduce pressure on the toe. Avoid high heeled shoes and allow enough room for your toes to spread
• Corn and callus removal: removing the hard skin and corns will provide some symptom relief
• Taping can help reduce symptoms
• Toe props and padding can help to reduce friction and pressure
• Orthotics: can help to realign the foot and provide padding to a dropped transverse arch.
• Surgical referral is sometimes required for rigid and extremely painful hammertoes once conservative measures have failed. Our podiatrists can refer for surgical opinion and management if required.

Early diagnosis and appropriate treatment of a hammertoe is important to prevent long-term complications that could impede mobility and daily activities.

If you are concerned about a hammertoe deformity come and see us at Melbourne Podiatrists and Orthotics for thorough assessment and treatment.

Do you have a hammertoe deformity?

At our Melbourne foot clinic our podiatrists are experts in toe deformities including hammertoes.

So if you have a painful hammertoe, book an appointment with one of our friendly Melbourne podiatrists today!