Hammertoes

A hammertoe bends at a joint in one of the smaller toes.It may become stiff over time.

Why it happens
Changes in the balance of muscles and tendons can pull the toe into a bent position. Tight shoes or an old injury can contribute.

 What you may notice
Shoe rubbing, a corn on the toe, redness or pain. More severe cases can cause an open sore.

 Why flexibility matters
A flexible toe can still be moved toward a straighter position. A rigid toe stays bent. This difference helps guide treatment. If you have reduced feeling or diabetes, the clinician may also check for nerve problems that could affect the toe muscles.

 Treatment and what to expect
A flexible toe may respond to padding, inserts or strapping. A stiff, painful toe may need surgery. Early assessment helps you choose care before the toe becomes harder to move. The exam checks whether the toe can still straighten and where it rubs. An x-ray may help show joint changes. Check the skin over the bent joint and between toes for sore spots.

 When to call
Call if the toe becomes more painful or stiff. Contact the office promptly for an open sore.

Your next steps
● Wear shoes with a deep, roomy toe area. Avoid pointed shoes and high heels.
● Use nonmedicated padding only as recommended. Avoid acid corn pads.
● Ask whether an insert, toe strap or splint could reduce pressure. Do not cut corns yourself. 

Making shoes and exercises work
Leave about half an inch beyond your longest toe; that may be your second toe. Choose a soft, deep toe area so the top does not rub.

Ask whether gentle toe stretches or towel-scrunching exercises are suitable. Have the clinician demonstrate them. Do not force a stiff or painful toe straight.

 If simpler measures do not help
Depending on flexibility, surgery may lengthen or move a tendon. A rigid joint may need fusion, which holds it in a straighter position as the bones join. A temporary pin or other hardware may be used. Discuss the expected toe movement, shoe needs and recovery before deciding.