Hammer Toes: Causes, Symptoms, and Treatment

What Are Hammer Toes?

Hammer toes occur when the middle joint of a toe becomes abnormally bent, creating a hammer-like shape. This deformity is most commonly seen in the second, third, or fourth toes, though it can affect any toe. Hammer toes can be flexible (where the toe can still be straightened) or rigid (where the toe is fixed in a bent position).

Causes of Hammer Toes

Muscle Imbalance

• Tight or Weak Muscles: An imbalance in the muscles that control the toes can lead to abnormal bending.

• Nerve Damage: Conditions such as diabetic neuropathy or stroke can affect the nerves controlling the muscles, contributing to hammer toe development.

Abnormal Foot Structure

• Flat Feet (Pes Planus): Fallen arches can place excess stress on the toes, causing them to bend abnormally.

• High Arches (Pes Cavus): High arches can also alter the alignment of the foot, leading to hammer toe formation.

External Factors

• Improper Footwear: Shoes that are too tight, narrow, or high-heeled can restrict toe movement and contribute to deformities.

• Trauma or Injury: Previous foot injuries can lead to muscle imbalances and the development of hammer toes.

Other Medical Conditions

• Rheumatoid Arthritis: Inflammatory conditions like arthritis can cause joint damage and result in toe deformities.

• Cerebral Palsy or Charcot-Marie-Tooth Disease: These neurological disorders can affect the muscles of the feet, leading to abnormal toe positioning.

Symptoms of Hammer Toes

• Toe Deformity: A noticeable bend at the middle joint of the toe, causing it to resemble a hammer.

• Pain and Discomfort: The affected toe may cause pain, especially when walking or wearing shoes.

• Corn or Callus Formation: Hard skin can develop on the top of the bent toe or at the tip due to friction with shoes.

• Reduced Mobility: Difficulty straightening or moving the affected toe, which can impact overall foot function.

• Swelling and Redness: In severe cases, the affected joint may become swollen and inflamed.

Diagnosing Hammer Toes

Clinical Examination

• A healthcare provider will perform a physical examination to assess the position of the toe, joint flexibility, and any associated pain.

• An evaluation of your gait (walking pattern) may also be performed to assess how the hammer toe affects movement.

Imaging Studies

• X-rays: X-rays can help determine the severity of the deformity, as well as identify any underlying bone or joint issues.

• MRI: In some cases, an MRI may be recommended to assess soft tissue damage or underlying conditions affecting the toes.

Treatment for Hammer Toes

Non-Surgical Treatment

1. Footwear Modifications

   • Proper Shoes: Choose shoes with a wide toe box and low heels to reduce pressure on the toes.

   • Orthotic Devices: Custom orthotics can help correct foot alignment and reduce stress on the toes.

2. Stretching and Strengthening Exercises

   • Toe Stretching: Stretching exercises can help improve flexibility and reduce tightness in the affected toe muscles.

   • Foot Strengthening: Exercises designed to strengthen the muscles in the feet and toes can help prevent further deformities.

3. Padding and Splints

   • Toe Pads: Soft pads or cushions can be used to protect the toes from friction and pressure.

   • Toe Splints: Night splints or toe straighteners can be used to gently straighten the toes while sleeping.

4. Pain Relief

   • Anti-Inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve pain and swelling associated with hammer toes.

   • Ice Therapy: Applying ice to the affected joint can help reduce inflammation and discomfort.

Surgical Treatment

If non-surgical treatments do not provide relief or if the deformity becomes more severe, surgery may be necessary. Surgical options for hammer toes include:

• Tendon Release: This procedure involves releasing or lengthening the tendons that cause the toe to bend, helping to straighten the toe.

• Joint Fusion: In more severe cases, the joint may be fused to keep the toe in a functional position.

• Bone Reshaping: Bone procedures may be used to realign the toe and improve its appearance and function.

Recovery Timeline

• Non-Surgical Recovery: Treatment with shoes, exercises, and padding may provide relief within 4–6 weeks, although symptoms can return if the underlying causes are not addressed.

• Post-Surgical Recovery: If surgery is performed, recovery typically takes 6–12 weeks, depending on the procedure. Post-operative care, including physical therapy, may be required to restore full function.

Preventing Hammer Toes

• Wear well-fitting shoes with plenty of room for your toes.

• Avoid high-heeled shoes or shoes with narrow toe boxes that can place excessive pressure on the toes.

• Regularly stretch and strengthen your feet and toes to maintain flexibility and prevent muscle imbalances.

• Address underlying conditions such as arthritis or neuropathy with appropriate medical care to prevent foot deformities.

If you are suffering from hammer toes, it's important to seek professional care to prevent further discomfort and complications. At Palms Physiotherapy & Allied Health, we offer tailored treatment plans to address hammer toes and restore your foot health. Contact us today to book an appointment and take the first step toward relief!