Sole Survival … solving your foot problems
A hammer toe is a toe that is contracted at the PIP joint which is the middle joint in the toe. This can potentially lead to severe pressure and pain. Ligaments and tendons that have tightened cause the toe’s joints to curl downwards.
There can be rigid or flexible hammertoes. Rigid ones are more severe because movement in the toe is very limited or nonexistent and is accompanied by pain and pressure on the top of the toe as well as the bottom of the ball of the foot where a corn or callus may develop. Flexible hammer toes can be straightened out manually but possess a tendency to contract if left alone.
What causes Hammer Toes?
Hammertoes result from a muscle imbalance which causes the ligaments and tendons to become unnaturally tight. This results in the joint curling downward. Arthritis can lead to many different forefoot deformities including hammertoes. Hammer digit syndrome contributes to the downwards pushing of the metatarsal bones which creates either a capsulitis or constant irritation to the metatarsals. The curling up of toes causes the natural fat pad to move forward promoting fat pad atrophy through disuse or thinning out until they are no longer able to support the foot and protect it against abnormal pressures. Tight footwear is an important factor in the cause of hammer toes as well as providing the pressure that causes the symptoms
What is the treatment for Hammer Toes?
Changing the type of footwear worn is a very important step in the treatment of hammer toes. When choosing a shoe, make sure the toe box (toe area) is high and broad, and can accommodate the hammer toes. A shoe with a high, broad, toe box will provide enough room in the forefoot area so that there is less friction against the toes on the top of the toes.
Other conservative treatments include using forefoot products designed to relieve hammertoes, such as hammertoe crests and hammer toes splints. These devices will help hold down the hammertoe providing relief. Gel toe shields and gel toecaps are also recommended to eliminate friction between the shoe and the toe, while providing comfort and lubrication.
Treatment for hammertoes depends on the severity of the deformity. When the toes first start to buckle, they can be straightened easily. If the problem is caused by flat feet, a podiatrist can fit the patient for custom molded orthotics that provide better arch support so the muscles work better together.
Without treatment, the soft tissues attaching to hammer toes and claw toes tighten by laying down adhesions that stick to the tendons and joint capsules to produce a rigid deformity. If this happens, surgery is usually required for adequate correction of the toe.
Arthroplasty is a minor surgical procedure that lengthens a shortened toe muscle. In this procedure, the podiatrist or surgeon makes an incision along the toe and trims the head of the proximal phalanx to straighten the toe.
If the affected toe still does not straighten sufficiently after arthroplasty, the podiatrist or surgeon can use a variety of progressive procedures to achieve the desired result.
If the toe will still not straighten, there is one final procedure that may restore normal mobility called an arthrodesis. This is the fusing of two bones, the middle and proximal phalanges. The surgeon removes the cartilage and bone from these two bones and presses them together where they meet. A temporary removable pin may be employed to ensure prompt fusion and good alignment.
These procedures require the patient to stay off his or her feet for several weeks. This may be inconvenient for a time, but with proper postoperative care, the patient can obtain the desired relief.
In this issue of Spavelous “Now You Are In The Know” we will look at:
- Dry Cracked Heel
- Hammer Toes
- Heel Pain
- Ingrown Toenails
- Perspiration Causes Foot Odor
- Swollen Feet
- Toe Deformities
- Foot Warts