Hammer Toes

Hammer toe, claw toe, and mallet toe refer to toes that take on a bent or contracted position in which muscles and tendons tighten and shorten.  Even though all three conditions look quite similar, they actually involve different joints of the toes.

  • Hammer toe forms in the middle toe joint.  Its bent appearance causes the toe to resemble the head of a hammer.
  • Claw toe forms in the base joint that joins the toe to the rest of the foot.  When this joint constricts, the toe takes on a claw-like appearance.  
  • Mallet toe is a deformity at the end of the toe.  As the end joint constricts, the end of the toe looks somewhat like a mallet.

Over time, as the joints continue to hammer, the cartilage, ligaments, and joints begin to deteriorate and fusion starts to occur.  At this point the center of the hammer toe will not be able to flatten down without surgery to repair and will cause corns that can add to the pain one experiences.

 

Symptom of Hammer Toes

As you get up and bare weight on your feet the toes feel as though they are contracting giving the feeling that you are gripping a towel.  The tops of the toes will be rubbing against the top of the shoe and will cause corns.  The metatarsal heads will collapse and the fatty pad under the metatarsal may move forwards giving the feeling of socks wading up under the toes. Pain can also occur under the metatarsal joints and numbness can develop down through the toes.  Most people with sever hammer toes may also experience discomfort across the top of your feet at the instep.

 

Cause of Hammer Toes

More often than not shoes are blamed for the hammer toes.  They say that to short and narrow, shoes with pointed toes, and shoes with high heels force the toes into an unnatural position.  And they are right.  But, I find a more muscular/skeletal breakdown as the primary reason for the deformities.  For that person with a very high arch, and as it begins to drop, the Plantar fascia tendon will draw inwards creating what is called the windless affect.  This will cause the toes to begin to hammer up.  Those experiencing over pronation will also cause the plantar fascia tendon to draw inwards, once again causing the hammer toes to develop.  Tight calves will reduce the range of motion at the ankle causing ove rpronation and tighting of the plantar fascia tendon, creating the hammer toes.  Tight calves can also prevent you from getting your heel down on the ground properly and keeping it down through the majority of the gait cycle, which in turn makes you go up on your toes and will cause you to grip aggressively.  Given adequate time in this position, the joints will deteriorate and fuse together in the hammer position. 

 

Treatment of Hammer Toes

Should any of the joints be fixed and rigid the only form of treatment to correct would have to be surgery.  However, should the joints be flexible then correction the hammer toes can be accomplished by addressing the cause.  For those causes discussed above the plan to correct the hammer toes would be to use three basic tools, Stretching, Over-the-counter arch supports or custom foot orthosis, and properly fitted shoes that will accommodate the supports and stabilize the foot.  A forefoot rocker may also deter the toes from hammering should you have a fixed big toe joint.  For a temporary relief to the hammer toes caused by the tight calves, adding a heel lift in both shoes will give some short term relief to the toes. Other shoes that can help in relieving the pressure on the tops of the hammer toes whoud be shoes with stretchable material.