Hammer toes is a contracture (bending) of one or both joints of the second, third, fourth, or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop. Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammer toes are flexible and the symptoms can often be managed with noninvasive measures. But if left untreated, hammer toes can become more rigid and will not respond to non-surgical treatment. Because of the progressive nature of hammertoes, they should receive early attention. Hammertoes never get better without some kind of intervention.
Wearing shoes that squeeze the toes or high heels that jam the toes into the front of the shoe. Other causes or factors in the development of hammertoes can include an injury such as badly stubbing your toe, arthritis and nerve and muscle damage from diseases such as diabetes. And, hammertoes tend to run in families, although it is more likely the faulty foot mechanics that lead to hammertoes that are inherited, not the hammertoes themselves. Hammertoe generally affect the smaller toes of the foot, especially the second toe, which for many people is the longest toe. It's uncommon for the big toe to be bent this way.
Some people never have troubles with hammer toes. In fact, some people don't even know they have them. They can become uncomfortable, especially while wearing shoes. Many people who develop symptoms with hammer toes will develop corns, blisters and pain on the top of the toe, where it rubs against the shoe or between the toes, where it rubs against the adjacent toe. You can also develop calluses on the balls of the feet, as well as cramping, aching and an overall fatigue in the foot and leg.
First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.
Non Surgical Treatment
Any forefoot problems that cause pain or discomfort should be given prompt attention. Ignoring the symptoms can aggravate the condition and lead to a breakdown of tissue, or possibly even infection. Conservative treatment of mallet toes begins with accommodating the deformity. The goal is to relieve pressure, reduce friction, and transfer forces from the sensitive areas. Shoes with a high and broad toe box (toe area) are recommended for people suffering from forefoot deformities such as mallet toes. This prevents further irritation in the toe area from developing. Other conservative treatment includes forefoot supports such as gel toe caps, gel toe shields and toe crests. Gel forefoot supports provide immediate comfort and relief from common forefoot disorders without drying the skin.
The technique the surgeon applies during the surgery depends on how much flexibility the person's affected toes still retain. If some flexibility has still been preserved in their affected toes, the hammer toes might be corrected through making a small incision into the toe so the surgeon can manipulate the tendon that is forcing the person's toes into a curved position. If, however, the person's toes have become completely rigid, the surgeon might have to do more than re-aligning the person's tendons. Some pieces of bone may have to be removed so the person's toe has the ability to straighten out. If this is the case, some pins are attached onto the person's foot afterwards to fix their bones into place while the injured tissue heals.
Some tips on how to avoid getting hammertoes when wearing high heels has to do with the shoes that you choose and what you do to your feet after you wear the high heels. A closed toe shoe like a stiletto pump is going to put more pressure on the front of the foot, forcing the toes to contract in and start forming the hammertoes. Women who start having hammertoes usually complain about pain in their feet when they wear the closed shoe, usually in the winter season, and when in the warmer weather and they wear the open-toed shoes, there?s much less pressure on the front of the foot and they experience much less pain.