A Hammer Toe occurs when the joint of the toes curl down. The reason they curl abnormally is due to a muscle imbalance which results in the tendons becoming unnaturally tight. They are due to Heredity, improper shoes, and Arthritis. There are two types of hammer toes, flexible or rigid. These classification are based on the mobility of the toe joints. A flexible hammer toe is one with a flexible toe joint that allows it to be straightend with your finger. In time a flexible joint may turn into a rigid hammer toe. Normally flexible hammer toes are much less painful than rigid hammer toes. A rigid hammer toe is one with a rigid toe joint, one that is not moveable with your finger. These rigid toe joints can be very painful and limit the ability to move.
Your shoes, your genetic predisposition, an underlying medical condition or all of these can make you susceptible to developing one of these deformities of the toes. The genes your parents gave you. When it comes to genetics, the foot type you?re born with predisposes you to developing this type of joint deformity over a lifetime. For many, a flat flexible foot leads to hammertoes as the foot tries to stabilize against a flattening arch. Those with high arches can also form hammertoes as the extensor tendons overpower the flexors.
If the toes remain in the hammertoe position for long periods, the tendons on the top of the foot will tighten over time because they are not stretched to their full length. Eventually, the tendons shorten enough that the toe stays bent, even when shoes are not being worn. The symptoms of hammertoe include a curling toe, pain or discomfort in the toes and ball of the foot or the front of the leg, especially when toes are stretched downward, thickening of the skin above or below the affected toe with the formation of corns or calluses, difficulty finding shoes that fit well. In its early stages, hammertoe is not obvious. Frequently, hammertoe does not cause any symptoms except for the claw-like toe shape.
Hammertoes are progressive, they don?t go away by themselves and usually they will get worse over time. However, not all cases are alike, some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.
Non Surgical Treatment
Putting padding between your toes and strapping them in place can help to stop pain caused by the toes rubbing. Custom-made insoles for your shoes will help to take the pressure off any painful areas. Special shoes that are wider and deeper than normal can stop your toes rubbing. However if your pain persists your consultant may recommend an surgery.
Sometimes when the joints are removed the two bones become one as they are fused in a straightened position. Many times one toe will be longer than another and a piece of bone is removed to bring the toes in a more normal length in relation to each other. Sometimes tendons will be lengthened, or soft tissue around the joints will be cut or rebalanced to fix the deformity. Angular corrections may also be needed. The surgeon may place fixation in your foot as it heals which may include a pin, or wires.
The best treatment is good prevention! Hammertoe can be prevented by wearing shoes with ample toe room, avoiding high heels, and wearing adjustable shoes to assure a looser fit. When buying shoes, shop at the end of the day when your feet are swollen from daily activity, try both shoes on to confirm they fit properly, and if necessary, visit a shoe repair store to see if they can stretch your shoes for a better fit.
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