What is a Hammertoe?
It is a deformity of the second toe which commonly occurs. It curls or permanently flexes downward, resulting in a claw like shape as a result of a bend in the middle joint of a toe.
Hammertoes are generally aligned with wearing narrow front or pointy tip shoes in women, and in men, the steel tip boots. For the most part, women are the main victims of this condition since the variety in wider width shoes is limited.
Shoes sometimes compress the feet and constrict the muscles that move the toes. Subsequently, the muscles waste away, and the motions of the toe become puny and weak. At the same time, the toe is deprived of the room it needs to function effectively.
In an ill-fitting shoe, the toe seeks room anywhere it can be found. The pressure on the sides of the toes, as they are squeezed together by narrow/restricting footwear, causes a toe to “hammer.”
As the pressure continues, the affected toe – the second or third, or sometimes both might rise, contract, and or overlap other toes. It is not uncommon for a hammertoe to move up and out of the line of toes, and become a digit that serves no purpose.
With many hammertoes, a hard corn forms in the area that is hammering due to the friction caused by it rubbing on the shoe. Soft corns and calluses on the tips of the toes may develop also.
Usually the second toe is first to be the victim of hammering. Although any toe may be affected, the second toe suffers most as it is longer than the other toes and therefore more likely to be deformed. The effects of a hammertoe are not limited to the toe. The toe bones, forced back against the metatarsals, exert pressure against the centre of the foot. The ball of the foot suffers, calluses form, and muscular cramps develop.
Signs, Symptoms and Causes
Signs and symptoms of hammertoes may include:
- A hammer-like or claw-like appearance of a toe
- Pain and difficulty moving the toe
- Corns and calluses resulting from the toe rubbing against the inside of your footwear
- Pain with walking and other foot movements.
The symptoms of a hammertoe are usually first noticed when a corn develops on the top of the toe and becomes painful, usually when wearing ill shaped or fitted shoes, or pantyhose. Most of the symptoms are due to pressure from footwear on the toe. There may be a callus under the metatarsal head at the base of the toe. Initially a hammer toe is usually flexible, but when longstanding it becomes more rigid.
Causes of hammertoes could also include:
- An injury in which you jam or break your toe
- Abnormal foot mechanics because of nerve and muscle damage to your toe resulting from diabetes (diabetic neuropathy)
- Other diseases that affect nerves and muscles, such as arthritis or stroke.
A number of approaches can be undertaken to deal with a hammertoe:
- It is important that any footwear advice is followed. The correct amount of space in the toe box will allow room for the toes to function without excessive pressure.
- If a corn is present, this will need to be treated.
- Padding is often used to get pressure off the toe to help the symptoms.
- Get fitted for Orthotics (arch supports).
- If conservative treatment is unsuccessful at helping the symptoms, surgery is the next option.
Surgery can be done to correct a hammertoe. However, there are several different types of procedures that can be used, depending on the foot structure and if the deformity is flexible or rigid.
The surgeon, employing minimal-incision techniques uses a power-driven tool to file away a small wedge of bone from the angle of the contracture. This is a painless procedure done under a local anesthetic and the patient is able to walk home. A few days of recuperation are, however, necessary. The toe is held in its corrected position by a small splint until fusion of the bone takes place, usually within a few weeks.
In an alternative minimal-incision procedure, a surgeon can lengthen the tendon. Eliminating the contracture of the tendons on the top of the foot strengthens the movement of the hammertoe so it can uncurl and straighten.
Your feet mirror your general health . . . cherish them!