is most common in women, and a big part of this is poor shoe choices, which
are a big factor in the development of many foot problems. Tight toe boxes and high heels are the biggest culprits. Genetics certainly plays a role in some cases of hammertoes, as does trauma,
infection, arthritis, and certain neurological and muscle disorders. Most cases of contracted toes are associated with various biomechanical abnormalities in how a patient walks. This causes the
muscles and tendons to be used excessively or improperly, which deforms the toes over time.
Hammertoes are a contracture of the toes as a result of a muscle imbalance between the tendons on the top of the toes (extensor tendons) and the tendons on the bottom of the toes (flexor tendons). If
there is an imbalance in the foot muscles that stabilize the toe, the smaller muscles can be overpowered by the larger flexor and extensor muscles.
If you have any of these symptoms, do not assume it is due to hammer toe. Talk to your doctor about symptoms such as a toe that curls down, corns on the top of a toe, calluses on the sole of the foot
or bottom of the toe, pain in the middle joint of a toe, discomfort on the top of a toe, difficulty finding any shoes that fit comfortably, cramping in a toe, and sometimes also the foot and leg,
difficult or painful motion of a toe joint, pain in the ball of the foot or at the base of a toe.
Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination,
the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the
degree of the deformities and assess any changes that may have occurred.
Non Surgical Treatment
Changing the type of footwear worn is a very important step in the treatment of hammer toes. When choosing a shoe, make sure the toe box (toe area) is high and broad, and can accommodate the hammer
toes. A shoe with a high, broad toe box will provide enough room in the forefoot area so that there is less friction against the toes. Other conservative treatments include using forefoot products
designed to relieve hammer toes, such as hammer toe crests and hammer toe splints. These devices will help hold down the hammer toe and provide relief to the forefoot. Gel toe shields and gel toe
caps are also recommended to eliminate friction between the shoe and the toe, while providing comfort and lubrication.
If pinning the toe is not required during the procedure, then the surgery could be preformed in the doctor's office under a local anesthesia. Some patients prefer the comfort of sedation during the
surgery and if this is the case or if a pin must be placed, then the surgery could be preformed in an outpatient surgery center.
Certain exercises such as moving and stretching your toe gently with your hands and picking up small or soft objects such as marbles or towels can keep your toe joints flexible, simple exercises can
stretch and strengthen your muscles. Limit high-heel use, well-designed flat shoes will be hammertoe
more comfortable than high
heels. Don't wear shoes that are too short or too narrow, or too shallow, this is especially important for children going through periods of rapid growth, the toe area should be high enough so that
it doesn't rub against the top of your toes.