Many people develop a condition in their feet called hammer toes.  A hammer toe exists when one or more of the smaller toes on your feet begin to curl.  They no longer stay straight when you stand on your feet.  Depending on where the bend in the toe occurs, they may also be called mallet toes or claw toes.  The most common cause of hammer toes is a biomechanical imbalance as we walk. The muscles and tendons that attach to the top and bottom of the toes are designed to pull with equal force on the toe.  This keeps them straight to act as levers for balance and stability as we push off during walking or running.  Unfortunately most of us have imperfect feet.  There is a subtle difference in the force theses tendons apply to the toes.  Over time this causes the toe to elevate and bend.  Once the toe gets out of position, the stronger tendon continues to pull the toe further.  Eventually the top of the toe becomes painful as it starts to contact shoes with each step.

There are additional causes of hammer toes.  One is wearing shoes that are too narrow or too small.  This can also cause to toes to function out of position and lead to the hammer toe deformity. A bunion deformity of the great toe can also lead to hammertoes. Finally muscle, nerve, or joint damage can lead to this problem as well.  This category includes arthritis, diabetes, or even stroke victims.

Treatment options for hammer toes varies on the duration of the condition and whether or not pain is associated with the toes.  Initially the toes are flexible and can simply be manually straightened.  At this point most people are unaware that there is a problem.  However as the condition progresses the toes become more fixed in the hammertoe position. As they become more rigid, the amount of pressure on the toes usually increases, which can lead to painful calluses or corns.  This is when most patients “discover” the problem and seek help.

If the toes are not painful the best or conservative treatment would include monitoring the toes and wearing shoes that are accommodating to the toes.  Once the toes become painful treatments can include pads or straps to cushion the toes or pull them in a direction that alleviates the pressure on the toes. If calluses or corns develop, debridements to remove the painful skin can also be beneficial. If the toes are rigid or the pain is limiting activities or shoes, sometimes surgery is required to straighten the toes.  These are usually procedures that can be performed which allow the patient to continue to walk on the foot with protective shoes during recovery.

For an interesting look at some celebrities with hammertoes, see the following link:

http://sassystreak.wordpress.com/2012/05/17/hammer-toes-of-the-rich-famous/

If you have painful hammertoes, feel free to call North Texas Foot & Ankle for an appointment so we can properly diagnose your condition and discuss in further detail treatment options.