What is a Hammertoe?
A hammertoe is a contracture of one or both joints of the 2-5 toes in your feet. This can ultimately lead to increased stress and force on the toes, causing further issues to arise. Hammertoes generally start as a very mild deformity and can progressively worsen over time. There are 2 stages of a hammertoe deformity: flexible and rigid. In the early stages, the toe can be flexed back to a ‘normal’ position, and as such treatment is generally noninvasive. However, as the toe stiffens and becomes a rigid deformity, treatment often requires surgical intervention. As such, due to the progressive nature of the deformity, they should be treated early.
What causes Hammertoe deformity?
The most common causes for hammertoe are a tendon imbalance. This can occur from a structural issue or neurological changes. Tight footwear, long toes, trauma, bunion development, and genetics can all play a part in hammertoe development and progression. It can occur secondary to neurological damage from strokes, spinal injury and certain disease progressions such as diabetes.
How is it diagnosed?
Our podiatrists at Mount Lawley Physiotherapy and Podiatry perform a thorough physical examination of the affected joint and surrounding soft tissue to diagnose the hammertoe and how much it has progressed. X-rays can be performed to determine any other joint damage or to assess the severity of associated bunions/arthritis in the foot.
Symptoms
Common symptoms associated with hammertoe include but not limited to:
Pain in the associated joint
Inability to flex or extend the toe
Calluses and corns on the top and/or side of the toe
Pain in the ball of the foot
Inflammation, redness and burning within the toe
Cosmetic appearance – contracture of the toe
Treatment options for Hammertoe?
Non-surgical treatment is often trialled first, particularly in cases where the deformity is still reducible. Conservative treatment generally involves
- Change in footwear. Wearing wider, softer shoes takes the pressure off the toe and allows straightening of the digit
- Orthotic devices to help control the tendon imbalance within your foot
- Injection therapy – cortisone injections can help to reduce pain and inflammation
- Custom-made devices – silicone devices can be made for your toe to help straighten the digit and allow relief from muscular tightness. These are easy to wear with all footwear
- Manual therapy and strengthening exercises – acupuncture of tight tendon groups and manual manipulation of the foot and toe can help to reduce pressure on the toe and allow full flexion of the digit
In fixed cases, surgical intervention is the best possible solution. Often, there is an associated bunion deformity, which can be operated on at the same time.
