Crooked Toes (Hammertoes)
Putting toes and hammers together often results in some major misfortune.
So, as you might imagine, the condition called hammertoes isn’t really an
ideal state for the digits of your feet. (Although really, it’s hard to say
whether the name came about because the toes resemble hammers, or simply
look as though they’ve been hammered.) When you have hammertoes, the joints
of one or more toes become semi-permanently or permanently bent, making the
middle joint of the toe jut up, just as if your toe had decided to take on
the shape of a tent (or maybe a pyramid, if you’re into ancient history).
Hammertoes often start out flexible, meaning you can still bend the
joint-it just tends to revert to the crooked position when you leave it
alone, although they do become inflexible over time. As the condition
worsens, the joints become locked in place, which is not the way joints are
supposed to behave.
Hammertoes may have several causes, but most commonly come about due to
muscle imbalances. The tendons pulling the toe inward may be stronger than
the ones that pull the toe straight, thus resulting in a toe that’s bumped
up in the middle. Hammertoes (or a tendency to develop them) might have
been something you inherited from your parents (or grandparents, or third
cousins), although they may also be caused or exacerbated by wearing shoes
that scrunch the toes up into a small space (i.e. shoes with tiny little
toe boxes and/or high heels-the usual lineup of suspects). They may also
develop due to an injury, such as a break in the toe, or arthritis.
Some people may not experience uncomfortable symptoms until their condition
is a little more advanced. However, the first sign that something’s up is
the visibly obvious bending of the toe upward at the middle toe joint,
making the toe look like a hammer or a claw. This may be followed by pain
or even corns on the top of that pointed toe joint (caused when your shoe
rubs against the raised toe), and calluses on the ball of your foot (they
form because the base of the toe is now jutting down abnormally and putting
extra pressure on the ball of the foot).
As things get a bit more severe, the joint itself may begin to feel stiff
and painful, and it may become inflamed (red, swollen, warm to the touch).
Eventually, you may not be able to move the joint very well, or at all.
It’s a good idea to go in to see your podiatrist when your toes begin to
take on that hammer-like or clawed appearance, especially if you’re finding
it painful to walk because of the condition. Your podiatrist will likely
make the diagnosis by examining your foot visually, and may test the joint
for flexibility and pain. He or she may also suggest X-rays in order to get
an insider’s look at what’s going on in your foot.
Treatment options are varied, and depend a great deal on how far progressed
your hammertoes are. For instance, when the joint’s still pretty flexible,
it may be possible to treat the condition entirely without surgery. This
will likely be accomplished by your podiatrist prescribing orthotics (fancy
shoe inserts designed specifically for you) that will help correct the
imbalance in your foot that’s causing the hammertoes. Plus, they’ll make
you more comfortable while they’re doing all that correcting. Your
podiatrist may also try taping the toes (that is-he or she will put tape on
the toes, not take the toes in for a session in a recording studio) in
order to straighten them and provide additional support. Exercising your
calves (the ones on your legs-not the ones on the farm) and toe muscles
will also help provide additional strength and stability for your foot.
There are also a few things you can do to relieve some of the painful
symptoms that come with hammertoes. You could try using pads to reduce the
pressure on the tops of your toes: hammertoe pads or corn pads may be
available over the counter, but you may want to avoid the medicated
ones-the acid in the medication may be harmful, particularly to those with
circulation problems. If your toe joint is swollen and inflamed, you can
try applying ice (20 minutes on, 40 minutes off, and always use a thin
towel between the ice and your skin) or taking anti-inflammatory medication
(ibuprofen, or you can talk to your podiatrist about a cortisone shot) to
reduce inflammation. Also, (and this may be an obvious one, but it’s a
method some people ignore), you should probably ditch the shoes with the
tight toes and high heels. Give your toes plenty of room in the toe box
(about half an inch past the end of each toe) and avoid heels over two
inches (and lower, if possible), since they tend to squish your toes into
the end of your shoe.
If doing all that doesn’t really seem to help, or if your toes have gotten
to the point where they refuse to bend at all (the stubborn little things),
then it may be time to consider surgery. Your podiatrist knows a lot of
options and can discuss which ones will be most likely to fit your
particular needs. For the more flexible kinds of hammertoe, a simple
release of the tight tendon may be all you need to get relief. This usually
involves only a very small incision and a pretty rapid recovery time
(although that recovery time gets longer if more toes receive the surgery).
Or, your foot surgeon may find it best to remove a little portion of the
bone from the joint in order to straighten it. This may also be paired with
a tendon release. In cases where the condition is pretty advanced, it may
be necessary to fuse the joint (which usually involves the insertion of
pins into the joint to hold it in place while it heals), remove wedges of
skin, or insert or rebalance the affected tendons.
Recovery time will vary, depending on what treatment method you use. But,
if all goes well, you can once again have toes that resemble toes, and not
something you find in a greasy toolbox.
Call 719-543-2476 today to schedule your appointment!