Hammertoes

A hammertoe is a progressive foot deformity where one of the lesser toes (typically the second, third, or fourth) bends downward at the middle joint, creating a hammer-like shape. This abnormal position causes the joint to rub against shoes, leading to painful corns, calluses, and inflammation.

While ill-fitting footwear is a common cause, hammertoes can also result from muscle imbalance, nerve damage, or arthritis. They often occur alongside bunions due to toe crowding. At Mountain Spine & Orthopedics, our foot and ankle specialists offer treatments ranging from conservative management to minimally invasive surgery to straighten the toe and relieve your pain.

Hammertoe symptoms progress from flexible (correctable) to rigid (fixed) if not treated.

• Visible abnormal bend in the toe at the middle joint
• Pain or irritation on the top of the bent toe when wearing shoes
• Painful corns or calluses on the joint or tip of the toe
• Redness and swelling at the affected joint
• Restricted movement of the toe
• Difficulty finding comfortable footwear
• Pain in the ball of the foot (metatarsalgia)

• Ill-fitting shoes: Tight, narrow, or high-heeled footwear crowds the toes
• Toe injury: Trauma can damage tendons and cause imbalance
• Muscle imbalance: Weakness or tightness in toe muscles
• Bunions: Big toe deformity pushes lesser toes
• Nerve damage: Diabetes or other neuropathies
• Arthritis: Joint inflammation and damage
• Genetics: Inherited foot structure
• Toe length: Second toe longer than the big toe

Diagnosis is made through physical examination of the foot. Our specialist assesses the structure of the toes and checks for flexibility or rigidity—a key distinction that determines treatment.

X-rays evaluate bone alignment and severity of the deformity. We also assess for related conditions like bunions and Morton's neuroma that commonly occur with hammertoes.

Treatment depends on whether the hammertoe is flexible or rigid.

Non-Surgical Treatment

• Wider shoes: Roomy toe box reduces pressure
• Corn pads: Cushion the prominent joint
• Toe splints/straps: Hold the toe in correct position
• Orthotics: Custom insoles reduce forefoot pressure
• Toe exercises: Stretching and strengthening
• NSAIDs: Reduce pain and inflammation

Surgical Treatment

For rigid hammertoes or when pain persists, hammertoe surgery provides permanent correction. Procedures include tendon release, arthroplasty (joint resection), or arthrodesis (joint fusion).

Pain from hammertoes arises from pressure and friction on the bent joint when wearing shoes, leading to corns and calluses. The abnormal joint position also causes inflammation within the joint. As the deformity progresses, pain becomes more constant and affects walking.

Protecting your toes starts with the shoes you choose and how you care for your feet daily.

• Wear proper shoes: Wide toe box, low heels
• Avoid tight shoes: Don't squeeze your toes
• Exercise your toes: Pick up marbles, scrunch towels
• Stretch toe muscles: Regularly extend and flex toes
• Treat bunions: Address bunions before they crowd other toes
• Monitor diabetes: Nerve damage increases risk
• Act early: Flexible hammertoes are easier to treat than rigid ones

If hammertoes are causing you discomfort or difficulty with shoes, schedule a consultation with Mountain Spine & Orthopedics to explore your treatment options.