What to Know About Hammertoe
Hammertoes are among the most pervasive foot conditions, and they can cause significant pain and discomfort. For this blog, the Reconstructive Foot and Ankle Institute is going to break down what defines the deformity, how to handle it conservatively, and a few surgical options we use to resolve the worst cases.
What Makes Hammertoes Happen?
Hammertoes occur when the toes bend downward at the middle joint, twisting into a shape resembling a hammer. This deformity can develop due to:
- Muscle Imbalance: When the muscles and tendons in your foot become unbalanced, they can pull the toes into an abnormal position.
- Improper Footwear: Shoes that are too narrow or lack adequate toe space can contribute to hammertoe formation.
- Genetics: Some people are predisposed to developing hammertoes due to an inherited foot structure.
Signs and Symptoms:
- A bent toe joint, often at the middle joint.
- Corns or calluses on top of the bent toe joint or formed via friction on the bottom of the foot.
- Pain, especially when wearing shoes.
- Difficulty walking or participating in activities.
Treatment Options
The good news? Hammertoes can be treated with conservative methods, including:
- Supportive Footwear: Switching to shoes with wide toe boxes and good arch support allows your toes to rest comfortably and reduces pressure.
- Orthotics: Custom-made inserts for your shoes can help realign your toes and improve overall foot function.
- Padding: Applying pads to corns and calluses can alleviate pressure and discomfort.
- Toe Straighteners: Gel toe crest pads, available at our offices, are highly effective. They gently reposition and straighten your toes when worn.
When Surgery Might Be Necessary
There are several different types of surgery for these problems. Often if conservative treatment doesn’t solve the problem then a tenotomy/capsulotomy can be performed to straighten the toe. This is a procedure that allows you to walk the same day, have the surgery in the office and requires no time off work. You will have your toe anesthetized with a small amount of anesthetic and the tendon (s) and or capsule on the bottom of the toe is cut. This will immediately straighten your toe and relieve the problem if it is a flexible deformity. If it a rigid deformity it may help to a point and it may be enough to avoid having a joint cut out of your toe. Consider a foot with a high arch and ten over decades gravity’s pull causes the ligaments in the foot to give a bit and the arch collapses. The foot gets larger because it is collapsing as the bones are less of an arch and are straighter caused by the ligaments giving out. What does not stretch is the tendon to each of your toes. They are like steel cables and as your foot gets larger or longer then they pull more and cause your toes to hammer. Releasing one or more tendons in your toe as well as a joint capsule often helps this. The neat thing about this procedure is that it heals very quickly and here is no time off work or school. You will not be able to curl your toe again as the tendons that do this are cut but the relief you get in a short amount of time is worth this in most cases.
If conservative measures fail to provide relief, podiatrists might perform various surgical procedures depending on the severity of the hammertoe.
One exciting new option is known as tenotomy. This minimally invasive method involves cutting a specific tendon to allow the toe to straighten. It’s often performed on flexible hammertoes, and many patients are able to walk right out of the office afterward!
The Reconstructive Foot & Ankle Institute offers comprehensive podiatric services! Call us at 301-797-8554 or contact us to schedule an appointment. Located in Hagerstown & Frederick, MD, we’re ready to meet any of your foot health needs.
Don’t forget Dr. Michaels’s motto: “If it’s below the knee, think of me!”