Hammertoes

A hammertoe is a deformity of the toe in which the toe is bent at the middle joint, causing it to resemble an inverted V or a hammer. Although any toe is susceptible to becoming a hammertoe, the condition most commonly appears in the second, third, or fourth toes. Left untreated, hammertoes can become inflexible and require surgery to correct.

Muscle Imbalance: An imbalance between the muscles, tendons, and ligaments that stabilize the toes can lead to abnormal bending.
Wearing Tight or Improper Footwear: Shoes that are too tight, narrow, or high-heeled can crowd the toes, forcing them into a bent position over time.
Trauma to the Toe: Stubbing, jamming, or fracturing a toe can damage its structure and increase the risk of deformity.
Arthritis: Inflammatory joint conditions can lead to structural changes and deformities in the toes.
Heredity: Inherited foot shapes or biomechanical tendencies can predispose a person to hammertoe.
High Arches (Pes Cavus): Increased pressure on the ball of the foot and toes from high arches may contribute to toe deformities.
Flat Feet (Pes Planus): Overpronation and instability associated with flat feet can alter toe mechanics.
Long Second Toe: When the second toe is longer than the big toe, it is more likely to be pushed into a hammertoe position by shoes.
Neuromuscular Disorders: Conditions such as Charcot-Marie-Tooth disease, cerebral palsy, or stroke can impair muscle control in the foot.
Diabetes: Nerve damage and changes in foot structure related to diabetes can increase the risk of hammertoe.
Advancing Age: Tendons and ligaments lose flexibility over time, making toe deformities more likely.
Female Gender: Women are more frequently affected, partly due to footwear choices.

Corns or calluses: Often develop on the top of the toe’s middle joint or at the tip of the toe due to pressure and friction from footwear.
Toe pain: Discomfort may be felt in the affected toe, especially when walking or wearing shoes.
Difficulty finding comfortable footwear: Shoes may feel tight or irritating due to the abnormal toe position, leading to discomfort during daily activities.

Footwear Modifications: Wearing shoes with a soft, spacious toe box and low heels helps reduce pressure and accommodate the natural alignment of the toes.
Orthotic Devices: Custom or over-the-counter orthotics can support proper foot alignment and relieve stress on the affected toe joints.
Padding and Taping: Using straps, cushions, or non-medicated corn pads can help reduce friction, pressure, and discomfort.
Physical Therapy and Toe Exercises: Gentle stretching and strengthening exercises can improve toe flexibility and may slow progression in flexible hammertoes.
Anti-inflammatory Medications: Oral NSAIDs can help reduce joint pain and inflammation. In some cases, steroid injections may provide temporary relief for localized swelling.
Surgical Intervention: In more severe or rigid cases, surgery may be recommended. Common procedures include tendon lengthening, tendon transfer, or joint resection to correct the deformity.