is caused when the middle joint (PIP) bends down towards the floor
(flexion). To compensate, the joints above and below (MTP, DIP) bend up (hyperextend). The result is that the middle part of the toe lifts up. Hammertoe is the most common deformity of the lesser
toes (i.e. not the big toe). It tends to only affect one toe, most commonly the second.
The incorrect position of the person's toes inside of their shoes also causes the formation of calluses or corns on the surfaces of their toes which are constantly bent as they are wearing
inappropriate shoes because the surfaces are consistently rubbing against the hard materials of the interior of the shoes causing regular friction.
The most obvious symptom of hammertoe is the bent, hammer-like or claw-like appearance of one or more of your toes. Typically, the proximal joint of a toe will be bending upward and the distal joint
will be bending downward. In some cases, both joints may bend downward, causing the toes to curl under the foot. In the variation of mallet toe, only the distal joint bends downward. Other symptoms
may include Pain and stiffness during movement of the toe, Painful corns on the tops of the toe or toes from rubbing against the top of the shoe's toe box, Painful calluses on the bottoms of the toe
or toes, Pain on the bottom of the ball of the foot, Redness and swelling at the joints. If you have any of these symptoms, especially the hammer shape, pain or stiffness in a toe or toes, you should
consider consulting your physician. Even if you're not significantly bothered by some of these symptoms, the severity of a hammertoe can become worse over time and should be treated as soon as
possible. Up to a point hammertoes can be treated without surgery and should be taken care of before they pass that point. After that, surgery may be the only solution.
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
Your doctor may prescribe some toe exercises that you can do at home to stretch and strengthen the muscles. For example, you can gently stretch the toes manually. You can use your toes to pick things
up off the floor. While you watch television or read, you can put a towel flat under your feet and use your toes to crumple it. Finally, your doctor may recommend that you use commercially available
straps, cushions or nonmedicated corn pads to relieve symptoms. If you have diabetes, poor circulation or a lack of feeling in your feet, talk to your doctor before attempting any
Surgery is the approach that is often necessary to correct hammertoe that fails to respond to nonsurgical management. Surgery is appropriate when the muscles and tendons involved in a hammertoe
problem have become so tight that the joints are rigid, misaligned and unmovable. There are a number of surgical techniques for dealing with the complex range of joint, bone, muscle, tendon and
ligament abnormalities that define each hammertoe's make-up. To correct a hammertoe deformity, the surgeon's goal is to restore the normal alignment of the toe joint, relieving the pressure that led
to the hammertoe's development (this should also relieve the pain, as well). To do this, he or she may remove part of the boney structure that creates a prominence at the top of the joint. Tighten or
loosen the muscles, tendons and ligaments around the toe joints. Realign the toe bones by cutting one or more and shifting their position, realigning muscles, tendons and ligaments accordingly. Use
screws, wires or plates to hold the joint surfaces together until they heal. Reconstruct a badly damaged joint or replace it with an artificial implant.
Hammertoe can usually be prevented by wearing shoes that fit properly and give the toes plenty of room. Don?t wear shoes with pointed or narrow toes. Don?t Hammer toe
wear shoes that are too tight or short. Don?t wear high-heeled shoes, which can force the toes forward. Choose shoes
with wide or boxy toes. Choose shoes that are a half-inch longer than your longest toe. If shoes hurt, don?t wear them.