04 Mar What is a Hammertoe and How is it Managed?
Hammertoe is a medical condition affecting the toes of the foot and causes an abnormal bend in the middle joint of the digit. The most affected toes are the second, third, and fourth toes of the foot.
Symptoms of hammertoe may include:
- An abnormal bend in the middle joint of more or even more toes. This may affect just one foot or both feet as well.
- It may be painful or difficult to move the affected toe.
- Complications may include corns and calluses forming on the feet due to the affected toes(s) rubbing against the inside of the shoes.
Causes and Risk Factors
Possible causes of hammertoe have been linked to the following issues:
- Wearing specific shoes – shoes with high heels or those with narrow toe boxes can crowd the toes in a space where they cannot lie flat and may end up being bunched up on top of each other. This puts the toes in a curled up position and after a period of time, the muscles and tendon get stiff and stay in this position. Ultimately, the toes may up staying in this position even when the affected individual isn’t wearing the offending shoes.
- Imbalances in the toe muscles – certain conditions, like strokes, can cause the muscles in the feet and toes to become unstable and may result in contraction of the toes.
- Injury or trauma – injury to a toe where the muscles tear or bones fracture may lead to hammertoe.
Risk factors for increasing the chances of developing hammertoe include:
- Advancing age.
- Being female since they are more likely to wear shoes with high heels and tight toe boxes.
- If the second toe of the foot is longer than the big toe, then this increases the risk of hammertoe in this digit.
- Chronic conditions such as diabetes and arthritis may also make one more prone to developing foot-related deformities.
Many foot, heel, and ankle problems can be avoided by making use of shoes that fit properly. It is suggested to look at the following factors when purchasing shoes:
- They must have an adequate amount of space in the toe box and one should try to avoid pointed shoes.
- Avoid high heels and rather use shoes with a lower heel.
- Try using laced or strapped shoes as they are adjustable and allow for room to be made for the foot.
- Try purchasing shoes at the end of the day as they swell and will be at their largest at this time.
- When buying shoes, they should feel comfortable and fit properly.
In cases where hammertoe already exists but the toe is still flexible the following treatment options are available:
- Wearing more comfortable shoes and/or using shoe orthotics or pads which help to reposition the affected toe to relieve pain and pressure.
- Exercises such as picking up small, round objects with the feet will be suggested and these will help to stretch and strengthen the muscles in the toes.
If these conservative measures don’t help, then surgical intervention may be considered. These surgeries may include:
- Releasing or transferring a tendon to help the affected part of the toe lie flat.
- Basal phalangectomy, which is a procedure where a piece of bone is removed to straighten the toe.