Hammertoes, like most foot deformities, tend to start out mild and small. You may notice that one or more toes start to stay in a bent position even when they’re at “rest,” but it’s easy enough to push them back flat with your fingers, and you might not have any noticeable pain or obvious activity restrictions.
Unfortunately (and also like most other foot deformities), hammertoes do not improve on their own and will only get worse. Today’s relatively minor flexible hammertoe maybe tomorrow’s rigid, painful, problematic hammertoe.
That is unless you do something about it! At Comprehensive Foot and Ankle Centers, our doctors provide a variety of both surgical and non-surgical treatments to help you prevent, manage, and if necessary correct a hammertoe. And the earlier you seek our help, the more treatment options tend to be available for you!
The Anatomy of a Hammertoe
So what is a hammertoe, anyway?
In this condition, one or more of the four “little” toes on either foot becomes permanently contracted in a bent position at the middle knuckle. Most commonly this is the second toe, but others are certainly possible, too. (A related condition, called mallet toe, occurs if the toe is bent at the joint closest to the toe tip.)
Physiologically, this is the result of an imbalance in the relative strength of the muscle and tendon pairs that normally work together to flex and extend the toe. If these pairs get out of balance with one another, the “strong” pair may pull the toe into a flexed position, with the “weak” pair not strong enough to pull it flat again.
Hammertoe Symptoms Get Worse Over Time
As mentioned previously, hammertoes are a progressive condition. In the early stages, the toe may not lie flat on its own while you’re barefoot, but it’s relatively simple to push the toe flat with your fingers or even tape it in place. There may not be any pain when hammertoes are at this stage.
Unfortunately, over time the situation worsens and the joint begins to rigidly “lock” into place. It may become difficult or impossible to push the toe flat. You’re also more likely to develop issues such as:
- Painful corns (or in severe cases, open sores) in spots where the toe presses up against the inside or bottom of your shoes
- Difficulty wearing any closed-toed shoes comfortably
- Arthritic pain in the toe joint itself
- Difficulty performing physical activities you used to enjoy
What Causes Hammertoes?
So how do muscle and tendon pairs become imbalanced? That depends on the specific situation, but some of the most commonly observed causes and risk factors include:
- Your inherited foot shape or structure. In particular, people who have second toes longer than their great toes are at higher risk. You also may have a foot shape or gait mechanics that naturally puts more pressure on the front portion of the foot. If your parents or grandparents had hammertoes, you may have inherited a higher risk.
- Poor footwear choices. Shoes and socks that bunch the toes together, don’t give them enough room to wiggle, or focus your body weight toward the toes and balls of the feet may aggravate or worsen your hammertoes.
- Toe injuries. Jamming, stubbing, or other trauma to the toes may begin the process of destabilizing the joint. The hammertoe may not appear for many years later.
Choosing A Treatment Plan for Hammertoes That Works For You
When it comes to treating hammertoes, our preference is always to use non-surgical options to address your pain, enable you to live your preferred lifestyle, and keep the hammertoe from getting worse (or at least slowing the deterioration).
Non-surgical treatments are most likely to be successful when the hammertoe is mild and still flexible. Options may include:
- Wearing shoes (and in some cases orthotics) that better accommodate the hammertoe and support the feet
- Wearing pads on the toe to protect it against corns, blisters, or sores caused by friction.
- Wearing toe spacers, hammertoe separators, or “buddy taping” to keep your hammertoe in a flat position (if the joint is still flexible).
If these techniques do not allow you to live your preferred lifestyle comfortably, or it’s clear from our initial evaluation that they would be insufficient, we will likely recommend reconstructive surgery instead.
Exploring Hammertoe Surgery
Hammertoe surgery is typically performed in an outpatient setting. There are a variety of surgical techniques that may be used, including tendon transfers, joint resection, or in some cases joint fusion. We’ll discuss all your options with you, including any pros or cons of each, so you can be confident in your choice. Regardless of the procedure, the long-term results are very good to excellent for the vast majority of patients.
After surgery, you can usually expect at least a few weeks of no or limited weight-bearing, followed by a gradual return to normal shoes and more vigorous activities. Full recovery time is about six to eight weeks for most people, although this can be faster or slower depending on the surgical procedure, your health status, and other factors.
Again, we will go over all this with you in detail, including what to expect and how to care for your toe after surgery, and before your procedure. And you can always call us anytime afterward if you have questions!
Get the Care You Need Today
We’ll say it one more time: the sooner you seek help for a hammertoe, the greater your chances of avoiding or at least delaying a surgical procedure—and of course, the less total pain you have to put up with.
To schedule an appointment at one of our six convenient locations in Missouri or Kansas, give us a call today at (816) 455-1155.