What is a hammer toe and what can a podiatrist do to fix it?
Hammer toe is a common deformity seen in the feet and happens when your toe bends downwards and looks like a hammer from the side view. Hammer toes tend to develop overtime but sometimes they can be present at birth or occur as a result of trauma to the toe.
Hammer toes appear on the second to fourth toes and are more common in women than men. Having a hammer toe can impact on your daily life and particularly the ability to wear shoes, which can lead to rubbing and sometimes form corns. They can be very painful but the good news is there are various treatments available. Read on to learn more about this condition and how we can help you in our foot clinics.
What is a hammer toe?
A hammer toe is where there is contracture or bending at the first joint in toe, called the proximal interphalangeal joint. A hammer toe can either be flexible or rigid.
Flexible hammer toes are still moveable and can be straightened with applied pressure, these are less severe. However, rigid hammer toes cannot be straightened with force and require more invasive treatment like surgery to be corrected.
What is the difference
Not all digital deformities are hammer toes, there are other issues that can become problematic and it is important to know the difference between them.
The toe bends at the first joint and can make shoes uncomfortable and cause pain and corns at the top of the toe.
Where your toes bend into a claw-like position and can dig down into the soles of your shoes, causing callouses.
The joint at the end of the toe buckles. It often happens to the second toe and puts extra pressure on the tip of the toe.
What causes a hammer toe?
Hammer toes 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. They are more common in the fifth and sixth decades of life, therefore progressive in nature, however trauma to the toe can cause a hammer to form at any time.
The following are factors that can lead to hammer toes developing:
- Bunions
- Medical conditions: diabetes mellitus, arthritis, synovitis, and some neurological conditions can cause hammer toes to develop
- Tight fitting shoes
- Trauma: blunt force trauma to the toe or plantar plate injuries
- A longer second toe
- Gender: women are more commonly affected than men
- Genetics
- Age
Symptoms of a hammer toe
The visual appearance of a hammer toe is its main symptom: a bent toe that resembles a hammer from the side view.
- Pain on top of the toe especially when wearing enclosed footwear
- Corns or callouses forming on top of the toe
- Redness and swelling where the toe bends
- Restriction or pain when straightening the toe
- Callouses forming on the ball of the feet at the base of the affected toe
Treatment for hammer toes
If you have any pain, you should see a podiatrist for treatment. Hammer toes are progressive in nature, if left untreated they can become rigid and will require complex treatment to correct.
What can a podiatrist do for a hammer toe? Firstly, all hammer toes will be assessed 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. During your initial assessment we will listen to your concerns and expectations regarding any pain or disability as well as cosmetic appearance issues and recommend treatment accordingly.
Most treatment of hammer toes is non-surgical, and the majority of patients find relief from it.
Treatment can consist of the following:
- Footwear changes: wearing wider shoes with a flexible upper, can reduce pressure on the toe
- Toe sleeves or padding: this can reduce pressure and irritation within footwear
- Taping: simply taping the affected toe can help reduce symptoms
- Corn and callous removal: removing hard skin and corns on the top of the toe can cause symptom relief
- Orthotic therapy: cushioning and offloading the base of the affected toe can help reduce symptoms by offloading those areas
- Surgical referral for rigid and extremely painful hammer toes your podiatrist can refer for surgical opinion and management
How to prevent hammer toes
Here are some ways you can prevent a hammer toe:
- Wear supportive well fitted shoes. Make sure they aren’t too narrow and have a reduced heel allowing space for your toes.
- If prescribed custom orthotics for certain foot conditions wear them to help prevent hammer toes forming as a complication.
- Visit your podiatrist at the first signs of a hammer toe developing
frequently asked questions
There are many ways to tape a hammer toe. We recommend using a toe strap which we can provide in our clinics for daily use. Constant taping can lead to skin irritation
Hammer toes can only be corrected by surgery. Padding and taping can help temporarily straighten or cushion painful joints
Hammer toe correctors can help straighten toes when wearing shoes but they do not permeantely correct hammer toes. Reduction or resolution in symptoms is good outcome for many people
Surgery can correct hammer toes.
If you have a painful hammer toe and are compensating when walking, it can cause you to limp and lead to other conditions such as knee pain
Hammer toes can be painful due to the joint rubbing in shoes or lack of movement when walking.
Bunions in some cases can cause hammer toes to form on the adjacent toe
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