HAMMER TOE

Do you feel pain in the toes other than the big toe? Do you have difficulty wearing shoes? Are you a fan of wearing shoes with pointed tips? If you answered yes to any of the questions, you might be at risk to experience hammer toe.

What is Hammer toe?

Hammer toe is a deformity wherein the lesser toes curl with the nails pointing downward. The second toe is commonly involved while the big toe is rarely affected. Corns or calluses that develop on the toe tip(s) are evidence of curling of the affected toe(s). The joint between the balls of the foot and toes can become straightened in association with this condition.

What are the causes of hammer toe?

The following are the common causes, but not limited to, developing hammer toe:

• Tight shoes

Shoes with narrow toe box cause cramping of the digits. In order to fit, the toes bend to accommodate the lack of space. Wearing this type of shoes habitually can lead to bending deformity of the toes.

• Charcot-Marie-Tooth Disease

Charcot-Marie-Tooth Disease is the most common inherited disease that produces damage of the nerves. The disease is associated with weakness of the foot muscles while maintaining adequate strength of the leg muscles. The discrepancy in strength between these muscles and numbness of the foot cause deformity of the toes during walking over time.

• Rheumatoid Arthritis

Advanced cases of rheumatoid arthritis lead to weakness of joints. This ultimately leads to the joints being almost lax and almost dislocated that is known as subluxation. Bending of the toes keeps the joints in place to prevent dislocation. This adjustment eventually leads to deformity of the toes.

• Old age

There are a lot of factors that come into play with aging as the cause of hammer toe. One would be weakness of the joints and muscles of the foot. Another would be reduced sensation of the toes. Reduced coordination and balance could also lead to curling of toes. Finally, reduced bone strength can be another cause.

Diagnosis of hammer toe

You may seek consult if you feel pain or notice overt deformities of the lesser toes, especially if the abovementioned causes are present. Feeling discomfort when wearing shoes can also signify the need for a physician consult. Diagnosis of hammer toe is made with a physician visit. X-rays are indicated only if there is suspicion of fracture or other bony abnormalities.

Treatment

• Use appropriate footwear

The size of the shoes should be at least ½ inch longer than the big toe to ensure that there is enough room for all the toes. Shoes with wide toe box are preferred for the same reason.

• Toe crests

Toe crests are soft pads worn underneath curled toes. The main use of toe crest is to relieve pressure on the toe tips in order to reduce discomfort.

• Rehabilitation

Strengthening of the muscles located in the soles of the foot can help prevent developing hammer toe. For those who developed the deformity, it will prevent further curling of the toes. Towel curl exercise is a good start to strengthen the foot muscles. Stretching the toes is also a good practice.  Here are tips on how to do them.

Towel curl exercise.

1. Spread out a towel over the floor.
2. Stand on one edge of the towel with the heel pressing against the floors and toes lifted and pointing toward the ceiling. Those with balance problems may do this sitting down.
3. Grab a piece of fabric towards you using all the toes while keeping the heels flat. Repeat until the free edge of the towel is drawn. Patience must be exhibited because only small part of the towel can be drawn with each curl.
4. Repeat for 3 times with 1 minute rest in between.

Towel stretch

1. Assume a long sitting position with a towel or resistance band near you.
2. Place the towel or band near the bottom portion of the toes.
3. Draw the toes and forefoot toward you and hold the stretch for 30 seconds. Elderly individuals should preferably hold the stretch for a minute if tolerated.
4. Repeat 3 times.