When the second toe bends up at the middle joint, it may be indicative of a condition that is known as hammer toe. This is considered a deformity and can cause difficulty in walking. In severe cases, these deformed toes can resemble hammers and may require surgery to straighten the affected toe permanently. Hammer toe can occur from genetic factors or from wearing high heels or tight shoes. Many times, these types of shoes do not provide adequate room for the toes to move freely. Some patients find mild relief when specific toe stretches are performed and custom-made insoles are worn. 

If surgery is performed, a full recovery can take several weeks, and a special shoe may need to be worn. If you suffer from hammer toe, please speak with a podiatrist when the first symptoms appear so that a proper diagnosis can be made and treatment can be started.

Hammer toes can be a painful condition to live with. For more information, contact one of our podiatrists of Northern Illinois Foot & Ankle Specialists. Our doctors will answer any of your foot- and ankle-related questions.

What is Hammer Toe?

Hammer toe is a foot deformity caused by an imbalance in the toe muscles, tendons, or ligaments that normally hold the toe straight. It can be caused by the type of shoes you wear, your foot structure, trauma, and certain disease processes.

Types of Hammer Toes

There are three types of hammer toes:

  1. Flexible hammer toes: This is an early stage of hammer toe where the toe can still be moved at the joint. It's called 'flexible' because the joints are still flexible.

  1. Semi-rigid hammer toes: This is the middle stage of the condition. In this stage, there is less movement in the toe because the condition is progressing but is not yet fully rigid.

  1. Rigid hammer toes: This is the final stage of the hammer toe. In this stage, the toe can't be moved because the tendons have tightened, and the joints have become rigid.

Symptoms of Hammer Toe

  • Painful and/or difficult toe movement
  • Swelling
  • Joint stiffness
  • Calluses/Corns
  • Physical deformity

Causes of Hammer Toe

Several factors contribute to the development of hammer toe:

  • Age: The risk of developing hammer toe increases with age.

  • Genetic Factors: Some people inherit the tendency to develop hammer toe. This means that if your parents or grandparents had hammer toe, you might be more likely to develop it, too.

  • Poor or Improper Footwear: Wearing shoes that don't fit well can cause the toes to bend and stay in that position for extended periods. Do not wear high-heeled shoes or shoes that are too tight, narrow, or short; these can force the toes into a bent position.

  • Neuromuscular Diseases: Conditions that affect the nerves and muscles can contribute to the development of hammer toe. For example, people with diabetes can develop nerve damage in their feet, leading to hammer toe.

  • Trauma/Foot Injuries and Certain Illnesses: Injuries to the toe, such as fractures, can cause a hammer toe or mallet toe. Other conditions that can cause inflammation and swelling in the feet, such as arthritis, can also contribute to the development of hammer toe.

  • Muscle/Tendon Imbalance or Tight Ligaments: An imbalance in the muscles, tendons, or ligaments that keep the toe straight can lead to hammer toe. Over time, this imbalance can cause the affected toe's muscles to tighten and the toe to bend into the characteristic hammer shape.

Diagnosis for Hammer Toe

  • Physical examination: A doctor examines the foot, looking at the shape of the toes and checking for signs such as pain, redness, swelling, or corns and calluses. They may also assess toe flexibility and range of motion. 

  • Medical history discussion: The doctor asks about symptoms, their onset, activities that exacerbate them, and family history of foot problems 

  • Footwear assessment: The doctor checks if the patient wears shoes that fit properly and if they might be contributing to the condition 

  • X-rays: If necessary, the doctor orders X-rays to see the bones in the toes and foot more clearly, confirm the diagnosis, and determine the severity of the hammer toe. 

After diagnosis, the doctor discusses treatment options, which may include changes to footwear, exercises, medications, or possibly surgery for severe hammer toe. 

Risk Factors of Hammer Toe

  • Age: The risk of hammer toe increases with age
  • Sex:  Women are more likely to have hammer toe compared to men
  • Toe Length: You are more likely to develop a hammer toe if your second toe is longer than your big toe
  • Certain Diseases: Arthritis and diabetes may make you more likely to develop hammertoe

Treatment of Hammer Toe

Treatment options for hammer toes include both surgical and nonsurgical approaches:

Nonsurgical Treatment:

Nonsurgical interventions are often the first line of treatment for hammer toes, particularly in the early stages.

  • Changing footwear: Avoiding tight, narrow shoes and opting for shoes with a wide toe box and low heels can help alleviate symptoms and prevent further progression.
  • Toe exercises and stretches: Specific exercises can help stretch and strengthen the muscles in the foot, improving flexibility and relieving pain.
  • Orthotic devices: Custom-made shoe inserts or pads can help support the arches and realign the toes, relieving pressure and discomfort.
  • Pain relief measures: Over-the-counter pain medications or topical creams may be used to manage pain and inflammation.
  • Corn and callus management: A healthcare provider can help remove painful corns and calluses that develop on the hammer toe.

Surgical Treatment:

  • Tendon lengthening: If the toe joint is still flexible, lengthening the tendons causing the imbalance can be a suitable surgical option.
  • Tendon transfer: Transferring tendons from the bottom to the top of the toe can help straighten the joint position for some patients with flexible toe joints.
  • Arthrodesis (joint fusion): In cases where the toe joint is rigid, tendon lengthening may be combined with arthrodesis. This procedure involves removing a small part of the bone in the toe joint and inserting wires, pins, or plates to hold the bones together while they fuse.

Take the Next Step Towards Healthy Feet

If you are experiencing symptoms of hammer toe or have any foot-related concerns, Northern Illinois Foot & Ankle Specialists can help. With offices in Lake in the Hills, Cary, Fox Lake, Crystal Lake, Hoffman Estates, Chicago, Elgin, and Hinsdale, IL, our team of skilled podiatrists offers the latest diagnostic and treatment technologies for various foot conditions. We are dedicated to providing personalized and comprehensive foot care to improve your overall foot health and quality of life.

Don't let hammer toe limit your mobility and cause unnecessary pain. Contact Northern Illinois Foot & Ankle Specialists today to schedule an appointment with one of our experienced podiatrists.

Frequently Asked Questions

Who is likely to get hammertoes?

Hammertoes can affect anyone, but certain factors, like being female, wearing high heels or tight shoes, and having foot abnormalities, increase the likelihood. However, anyone can develop hammertoes regardless of gender or age.

Do hammertoes cause pain?

Hammertoes can be painful, especially when pressure is placed on the affected toe(s). Pain is often experienced when walking or wearing shoes that don't provide enough room for toe movement. In some cases, corns or calluses may develop, adding to the discomfort.

When is surgery recommended for hammertoes?

Surgery may be recommended for severe or persistent hammertoes that do not respond to nonsurgical treatments. It can also be considered if the deformity is causing significant pain, difficulty walking, or affecting daily activities. Surgical procedures aim to correct the toe alignment and restore normal function.

Can hammertoes be fixed without surgery?

Non-surgical treatments like orthotic devices, exercises, and proper footwear can help manage hammertoes. However, severe cases may require surgery. Consult a healthcare professional for evaluation and recommendations.