Do the tips of your toes point downward rather than straight ahead? Does a bend or curl in your toe cause the joint to rub against your shoe? If so, hammertoes may be your problem.
Muscle-tendon imbalances in the feet are responsible for these unwanted bends. Foot mechanics like high arches and flat feet, or neurological changes like diabetic neuropathy can cause muscle-tendon imbalances. Hammertoes often accompany bunions – another condition caused by muscle imbalances in the feet.
“People usually start out with flexible hammertoes, meaning the affected toes are bent when the foot is relaxed and flatten out when they put weight on their foot,” said Dr. Amy Jaeger, a Marshfield Clinic podiatrist. “Hammertoes become more rigid over time. The toes stay bent whether the foot is relaxed or bearing weight.”
Early treatment can slow progression
Mild flexible hammertoes usually don’t cause discomfort. However, you should see a podiatrist if you notice your toes curling because you can slow the progression to rigid hammertoes with early treatment.
Get shoes with a deep, roomy toe box. Wear shoes with soft fabric in the toe box if your toes are painful. Avoid shoes that are too short, pointed, or have heels higher than 1.5 inches.
“High heels force your bodyweight onto the front of your feet, which pushes your toes into a curled position and can cause pain,” Jaeger said.
Orthotics that control muscle imbalances and splints to keep your toes pointing straight ahead can prevent pain and slow the progress of hammertoes. Unfortunately, they won’t permanently fix the muscle imbalance.
If your toes become painful, your doctor may recommend non-medicated corn pads or hammertoe crest pads to prevent rubbing, over-the-counter pain relievers or cortisone injections.
Severe rigid hammertoes may require surgery
Hammertoes may rub against your shoes and cause callouses and corns. Rubbing can form open sores that cause soft tissue or bone infections. The muscle-tendon imbalances can cause balance and gait problems for some people.
Your podiatrist may suggest surgery when hammertoes start causing painful symptoms. Surgery may involve reforming the joint, placing implants to keep muscles in the correct position or partial amputation in the most severe cases.
“Surgery is only for rigid hammertoes that are symptomatic,” Jaeger said. “It’s not for people who don’t like how their toes look.”