Hammer Toe
What is Hammer Toe?
A hammer toe is a deformity in which one of the toe joints (often the proximal interphalangeal joint) becomes bent, causing the toe to curl downward.
- Typically affects the second or third toe
- Exacerbated by tight or high-heeled footwear
Overview of the Condition
Muscle imbalances, toe length discrepancies, or ill-fitting shoes can lead to progressive deformity. Over time, the toe remains in a flexed position, causing pain and calluses.
Symptoms
- Toe bent upward at the middle joint
- Pain or irritation when wearing shoes
- Corns or calluses on the top of the bent joint
Causes
Tight shoes or high heels push the toes into a bent position over time. Muscle imbalances in the foot can also contribute, leading to sustained flexion of the toe.
Diagnosis
A clinical exam notes the deformity and toe flexibility (rigid vs. flexible). X-rays help assess joint alignment and rule out other pathologies.
Treatment Options
- Changing to roomier footwear
- Toe exercises and splints
- Orthotics to correct foot mechanics
- Surgical correction for persistent or rigid deformities
Conservative Management
Relief can be obtained through shoe modifications, padding corns or calluses, and performing exercises to stretch and strengthen the toe muscles.
Rehabilitation Exercises
- Towel curls or picking up marbles with the toes
- Gentle toe stretching and manipulation
- Using toe spacers or splints to straighten the joint
When is Surgery Needed?
Surgery is considered if the toe is rigid or causes significant pain that interferes with daily activities. Various procedures can realign or fuse the joint.
Surgical Procedures
- Tendon release or lengthening
- Joint resection or fusion (arthrodesis)
- Implant-based correction for severe deformities
Anatomy Overview
The lesser toes are controlled by a balance of flexor and extensor tendons. Imbalance or prolonged bending leads to contractures at the PIP joint.
Affected Areas
- Proximal interphalangeal (PIP) joint of the toe
- Surrounding soft tissues and tendons
- Skin overlying the bent joint (corns, calluses)
Frequently Asked Questions
| Question | Answer |
|---|---|
| Can a hammer toe be reversed without surgery? | Flexible deformities may improve with splinting and exercises. Rigid toes often require surgery. |
| Is hammer toe surgery painful? | Discomfort varies, but modern techniques and post-operative pain management help control pain effectively. |
Prevention Strategies
- Wear shoes with adequate toe room
- Avoid high heels for prolonged periods
- Strengthen foot muscles with regular exercises