Help for Your Hammertoes

Throughout life, we may come to many bends in the road. Bends in the toes, however, are a little less pleasant.

A hammertoe is a deformity that can occur in any of the smallest four toes on either foot, although it’s most common on the second digit. Due to a muscle imbalance, the toe begins to bend downward at the middle joint, evoking the shape of a hammer.

The Progression of Symptoms

Apart from the obvious visual deformity, a condition can cause pain and make it difficult to find shoes that fit correctly, or even to walk comfortably.

Hammertoes start out in a relatively flexible state—although they “default” to a bent position, you can still push them straight again with your fingers or hold them there with splinting or taping. However, in time the joint becomes more rigid.

Because the downward bend in the joint causes the tip of the toe to dig downward and the middle to arch upward, corns and calluses can develop at these pressure points if they’re rubbing against the inside of shoes. The problems are generally worse for a rigid hammertoe than a flexible one.

Contributing Factors to Bent Toe Joints

We don’t always know the exact cause of a toe deformity, aside from the muscle imbalance that ultimately develops. However, factors known to increase your risk include:

  • Genetics—some feet are more susceptible, particularly if you have flat feet, high arches, or a second toe that is longer than your first.
  • Toe injuries—stubbed, broken, jammed, etc.
  • Footwear—shoes with high heels or those that are narrow or pointed in the front section and crowd toes can either cause hammertoes or make the problem worse.

Door Number One: Conservative Treatment Approaches

Broadly speaking, you have two choices when it comes to hammertoes—attempt to manage the symptoms through conservative treatments, or fix it with surgery. Although that’s a decision that must be made carefully between patient and medical team, if the toe is still flexible, many patients opt to try door No. 1 first—you can always pick surgery later, after all.

Start with roomier, more supportive shoes that give your arcing toes the space they need to move comfortably. You might be able to find these off the rack, or you may need special shoes (or a good shoe repairman to stretch your existing pairs). If flat feet, high arches, or another underlying structural quirk is found to be a contributing factor, we may also recommend a good shoe insert or get you fitted for a custom orthotic.

Other non-invasive options for a flexible hammertoe include metatarsal pads, splinting or taping the affected toe(s) so that they lie flat, and physical therapy exercises to help restore muscle balance to the greatest extent possible.

Door Number Two: Surgical Correction

If your toe is rigid and causing significant problems, or you’ve tried conservative therapies and found them wanting, you may opt for surgical correction instead.

Surgical methods and planning will vary depending on how many toes are affected, how severe the problem is, what your long-term lifestyle goals are, and other factors. Our team always takes the time to listen carefully to your needs as well as perform a thorough examination to determine the best possible course of action for your unique situation.

Simpler cases may require only tendon transferring or bone shaving; however, most of the time bones will need to be cut and repositioned in order to address the underlying cause and allow the toe to lie flat again. The most serious cases may require joint fusion to adequately correct the deformity and eliminate pain.

As with any surgery, carefully following all aftercare instructions—including when you can walk or drive, how soon you can start physical therapy, etc.—is a critical component of achieving full healing in the shortest possible timeframe. That’s why we’re committed to making sure you and any other care providers are fully educated and provided with detailed instructions for home care.

Regardless of whether or not you’re “ready” for surgery, the most important thing to remember is that the earlier you stop by our office, the more options you’ll have at your disposal. Don’t wait until your hammertoes are rigid and painful and you can’t fit in shoes anymore! Call the Kansas Foot Center in Wichita, KS at 866.222.5177 and set up your appointment today.

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