is a contracture of the toes as a result of a muscle imbalance between the tendons on
the top and the tendons on the bottom of the toe. They can be flexible or rigid in nature. When they are rigid, it is not possible to straighten the toe out by manipulating it. Frequently, they
develop corns on the top of the toe as a result of rubbing on the shoe. They may also cause a bothersome callous on the ball of the foot. This occurs as a result of the toe pressing downward on the
bone behind the toe. This area then becomes prominent and the pressure of the bone against the ground causes a callous to form.
Footwear can contribute significantly to the development of hammertoes. Shoes that are too small force your toes into a curled position. Over time, your toe tendons adjust to this positioning,
causing your toe or toes to hold a hammered shape. Athletes may be especially susceptible, because of the increased forces on the toes from shoes that are too small or tight. Heel elevation in
footwear is also problematic, as it causes your toes to be pushed into the shoe?s toe box. Heel elevation additionally contributes to muscle imbalance. A common example of this is when your Achilles
tendon-the tendon at the back of your leg that attaches your calf muscles to your heel bone-is too tight, causing the tendons on the top of your foot that attach to your toes to work too hard and
hold your toes in an unnatural, elevated position.
At first, a hammertoe or mallet toe may maintain its flexibility and lie flat when you're not wearing crowded footwear. But eventually, the tendons of the toe may contract and tighten, causing your
toe to become permanently stiff. Your shoes can rub against the raised portion of the toe or toes, causing painful corns or calluses.
The treatment options vary with the type and severity of each hammer toe, although identifying the deformity early in its development is important to avoid surgery. Your podiatric physician will
examine and X-ray the affected area and recommend a treatment plan specific to your condition.
Non Surgical Treatment
If you have hammer toe, avoiding tight shoes and high heels may provide relief. Initial (non-surgical) treatment for hammer toe involves wearing shoes with plenty of room in the toe area. Shoes
should be at least one-half inch longer than the longest toe. Stretching and strengthening exercises for the toes (such as picking up items with the toes or stretching the toes by hand) are also
recommended. Sometimes orthopedists recommend special pads, cushions, or slings to help relieve the pain of hammer toe.
Hammer toe can be corrected by surgery if conservative measures fail. Usually, surgery is done on an outpatient basis with a local anesthetic. The actual procedure will depend on the type and extent
of the deformity. After the surgery, there may be some stiffness, swelling and redness and the toe may be slightly longer or shorter than before. You will be able to walk, but should not plan any
long hikes while the toe heals, and should keep your foot elevated as much as possible.
There should be at least one-half inch between the tip of your longest toe and the front of the shoe. Never buy shoes that feel tight and expect them to stretch with wearing. If you have prominent
areas on your feet such as hammertoes and bunions, avoid shoes with a lot of stitching or multiple pieces of fabric, as these stitched areas tend not to stretch to hammertoe
accommodate various toe deformities.