What is Hammer Toe?

An example of serious hammer toe on multiple toes

What causes hammer toe?

hammer toeHammer Toe, or in some instances, referred to as Claw Toe, is a condition that develops due to abnormal forces in your toes. This is a deformity that I’m sure you have seen before and potentially may even have had for some time. This is a condition where the toe curls up and the middle knuckle of the toe becomes more prominent. The toe can sometimes even tilt to one side or the other. Hammer toe or claw toe can, unfortunately, cause problems in several ways. It can cause pressure at the tip of the toe because of the toe curling and then in creating pressure at the tip, it can also cause pressure at the top of the toe because of the knuckle becoming more prominent as this deformity develops. Hammer Toe can also cause calluses, pressure pain, redness, sometimes even ulcers or open sores because of the pressure that it is creating. In other cases, Claw Toe or Hammer Toe creates pressure on the ball of the foot because as it starts to deform, the joint that connects it to the foot can dislocate or separate itself from the foot. And as it does so, it pulls the pad away from the bottom of the foot creating more pressure underneath.
Claw toe typically manifests with the toe developing a buckle on the top that can deviate from one side to the other side, depending on the deformity that develops and the way that this claw toe happens. This can happen for several reasons. It can happen because of genetics or you may have been predisposed to this condition. A bunion can also cause pressure on the toe which in turn causes that toe to stretch ligaments, making the toe deform. In addition, this can happen because of cramping, from abnormal shoe wear or improper shoe wear. And it can also happen because of injury that develops because of stretching of ligaments.

How to prevent a hammer toe

hammer toe tape
Taping of the toes can, in some cases, help to alleviate hammer toe.

You know you have a claw toe or a hammer toe because of the deformity that that is quite noticeable and then also the pain that’s associated with it. From home, there are few things that you can do to help to prevent or at least to take care of a claw toe and to reduce symptoms from it. The first thing to do is to look for shoes that don’t cause pressure on the toe. This may seem obvious but sometimes it’s difficult thing to find. Generally what you’re looking for in a shoe that prevents this pressure is a shoe that has a wider or deeper toe box so that pressure on the top of the foot doesn’t occur and also to allow more room for all your toes. In addition, sometimes a stiffer sole to the shoe or at least to the ball part of the shoe can also reduce pain and can reduce stretching and stresses on those toes. If you use more of a cushioned insole the shoe, then you have less pressure underneath and that can help to improve some of those symptoms as well. There are several items on the market that can help you as well, before you see your physician or you doctor for this. And some of those things can be toe straps to pull the toe down or hold it in place; toe spacers. There are even some straps that are designed to be able to hold all of your smaller toes in place, as almost separate sleeves on a little bit of a pad underneath the foot. Many of these things can be very helpful. If you develop calluses, then callus products can help you, including callus pads and then also devices to help to remove some of those calluses that develop. Once all of these items have been tried, then it’s appropriate for you to seek medical care if you feel like you’re having continued pain or if you’re starting to notice that you’re getting progressive ulcers or calluses or other signs, potentially of pressure problems.

If you use more of a cushioned insole the shoe, then you have less pressure underneath and that can help to improve some of those symptoms as well. There are several items on the market that can help you as well, before you see your physician or you doctor for this. And some of those things can be toe straps to pull the toe down or hold it in place; toe spacers. There are even some straps that are designed to be able to hold all of your smaller toes in place, as almost separate sleeves on a little bit of a pad underneath the foot. Many of these things can be very helpful. If you develop calluses, then callus products can help you, including callus pads and then also devices to help to remove some of those calluses that develop. Once all of these items have been tried, then it’s appropriate for you to seek medical care if you feel like you’re having continued pain or if you’re starting to notice that you’re getting progressive ulcers or calluses or other signs, potentially of pressure problems.

What to expect when you see your doctor

hammertoe
Surgery may be required to completly heal a hammer toe.

When you see your doctor, for a hammer toe or a claw toe, he will initially take x-rays of your foot and determine how much and how severe the deformity is and how much you would expect it to progress and create additional problems. Then he may also suggest some of the things that we’ve talked about that you can choose for home remedies. Including the straps and the pads and so forth. He may even have you do some taping of your toe, to maintain its position for a period of time. These things all give some help but cumulatively, probably only have about a 30-40% chance at best, of resolving symptoms from a hammer toe. When a hammer toe or claw toe becomes more significant, then it’s appropriate for surgical treatment to take place. There are several ways that the hammer toe can be corrected. The most common way is to either remove or fuse the middle joint of the toe. When that middle joint is fused, then that toe remains a little stiffer. But, becomes balanced and doesn’t tend to ride up or shift to the side, like it did, previously.
Fusion can occur through several ways. It can happen through just a flat cut of the bone. Or, a fusion can occur through some type of a device, a reaming device for example, that helps to stabilize the toe. The FootMind reamers are the ones that I use in my practice and have been very helpful in maintaining stability for hammer toes. Another way that a hammer toe can be corrected includes the use of a tendon transfer form the bottom of the toe to the top of the toe, to stabilize the toe. And this can only be done when the toe has remained flexible and hasn’t become stuck in a position. There are different, other additional procedural parts to helping a hammer toe, which can include tendon releases, other types of tendon transfers and different types of fixing the toe, after surgery.