What You Need To Know About Hammertoes

Hammertoes are a very common problem we see as podiatrists. If they are not treated, they can lead to pain and skin irritation.  More problems can occur with hammertoes, so we recommend treating these as soon as you notice the problem developing.

Hammertoe is a generalized term that we use to describe a toe that is contracted. This is typically a flexion contracture where the tip of the toe is gripping the ground and the middle of the toe sticks up in the air. We see pain generated from these either over the tip of the toe or on the top knuckle in the middle of the foot at the proximal interphalangeal joint, which mostly seems to cause pain from rubbing on shoes.  There are technically several different types of deformities that can form that are generally called hammertoes and also include a mallet toe and a claw toe.

Hammertoes form because of several different reasons. Some people genetically inherited hammertoes from their family. Hammertoes also form from several different ways we walk. One is called flexor stabilization where the toes grip the ground to stabilize the foot more than they should.  This happens with walking and weightbeaing and it seems to happen more in an over pronated (or flatfoot) foot type.

The next reason we see hammertoes develop is from flexor substitution. This occurs when the flexor tendons to the toes are working to try to push off the ground because the Achilles tendon and other muscles and tendons are not working correctly or are weakened. We see this happen commonly after Achilles injuries.

The last reason we see hammertoes develop is called extensor substitution. This happens when people have a weak anterior tibial muscle and tendon, so the extensor tendons try to work harder to pull the toes up as we walk through the swing phase of gait.

Conservative treatments for hammertoes involve shoe modification with an extra depth shoe and padding. Silipos pads can be used over the dorsal skin irritation area around the proximal interphalangeal joint. Toe crest pads can also be helpful if you are getting pain at the tip of the toe when the toe is contracted.

If conservative treatments do not alleviate the pain, hammertoes can be surgically straightened. To straighten a hammertoe, we typically need to remove some bone from 1 of the joints and then place either temporary pin fixation or screws or other type of hammertoe implants to hold the toe straight more long-term.

If you are suffering from any foot and ankle pain, call your expert Colorado Springs foot and ankle surgeons today at 719-488-4664, so we can help you!

Dr. Matthew Hinderland Board Certified Podiatrist and Foot and Ankle Surgeon

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