The unnatural position of a hammertoe deformity can cause persistent foot discomfort that makes it difficult to walk and leaves you vulnerable to developing painful corns and calluses. Luckily, there’s a lot you can do to relieve bothersome hammertoe symptoms, ranging from conservative measures to surgery.
As board-certified orthopedic surgeons who specialize in hammertoe treatment, our team at Sports Medicine Oregon help you alleviate bothersome symptoms of early deformity, stop or reverse its progression, and correct advanced, rigid hammertoe deformities with surgery.
Here, our seasoned foot and ankle experts explore the ins and outs of a hammertoe deformity, including why it occurs, how it progresses, and what you can do to minimize its symptoms — or eliminate its impact altogether.
Understanding hammertoe deformities
Hammertoe is the medical term used to describe deforming and progressive joint changes in one or more of your toes. Specifically, a hammertoe deformity is characterized by a stiff bend at the middle toe joint that prevents your toe from lying flat and straight.
When your toe’s middle (second) joint is always bent, your toe arches upward in the middle and curls under at the toe. Viewed from the side, a hammertoe deformity looks something like an inverted V.
Mallet toe is a similar condition that affects the third joint at the end of the toe; a claw toe deformity affects the first and second toe joints.
Hammertoe typically appears in the second, third, or fourth toe (middle toes), also known as your lesser digits. It’s exceptionally rare for the big toe or pinky toe to develop the condition.
No matter which toe it affects, hammertoe usually progresses from a “flexible” and readily treatable condition to a “rigid” condition that generally requires surgery:
In the early stages of a hammertoe deformity, the affected toe joint is still relatively pliable and easy to move. Flexible hammertoe is less serious because it responds well to treatment and can usually be kept in check with proper care.
When hammertoe progresses unchecked, the affected toe starts to become more rigid. A semi-rigid hammertoe is one that’s becoming less flexible as it’s starting to stiffen.
With rigid hammertoe, the tendons in the affected joint are so tight that the joint becomes fixed, or completely immobile. It’s most common in people with severe arthritis and those who don’t seek early treatment interventions for flexible hammertoe.
Why do I have a hammertoe deformity?
The most basic underlying cause of a hammertoe deformity is a structural imbalance between the muscles, tendons, or ligaments that normally function to keep the toe straight and flat.
A hammertoe deformity can have a variety of contributing causes, including:
- Wearing narrow, tight-fitting, or high-heeled shoes
- Sustaining trauma like a severe stub or toe fracture
- Having severe arthritis that affects the toe joints
- Having imbalanced toe muscles that cause instability
Some people are genetically predisposed to hammertoe deformities because they have an inherited foot structure that makes them prone to the condition. Women are much more likely to develop hammertoe than men, especially as they get older.
How can I ease hammertoe symptoms?
Hammertoe deformities can be quite painful, making it hard to move the affected toe or find comfortable shoes. Some people also experience redness and swelling around the joint contracture, or pain in the ball of the foot near the affected toe.
Apart from general toe and foot discomfort, the most common complaints of hammertoe are the middle joint of the toe rubbing against the top of the shoe, or the tip of the toe digging into the ground, either of which can lead to the development of painful corns or calluses.
Flexible and some semi-rigid hammertoe deformities can usually benefit from conservative treatment measures, including:
- Correcting faulty foot mechanics that contribute to imbalanced toe muscles
- Physical therapy exercises to stretch and strengthen affected toe muscles
- Footwear changes; switching to low-heeled shoes with a soft, roomy toe box
- Using custom orthotics to reposition your toe, relieve pressure, and ease pain
- Placing insulated padding around the hammertoe to help minimize pressure
- Relieving pain with an anti-inflammatory medication or cortisone injection
It’s always best to treat a hammer toe deformity as early as possible, simply because a toe joint that’s still flexible can often be relaxed and repositioned without surgery.
When is corrective surgery the right option?
If a conservative treatment approach doesn’t provide adequate relief, or if your hammertoe deformity is already too rigid to benefit from early intervention techniques, corrective surgery may be the best treatment solution.
Depending on the nature and severity of the deformity, surgery may involve releasing a tight tendon, removing a bony prominence, or restoring normal alignment.
Whether you need help managing hammertoe symptoms or you’re already thinking about corrective surgery, the skilled orthopedic team at Sports Medicine Oregon can help. Call your nearest office in Tigard or Wilsonville, Oregon, today, or schedule a visit online any time.