Crooked Toes and Open Shoes
One of the most common foot problems is hammer toe, and it often arrives with no warning.
One of our patients said she was informed that she had a hammer toe only when a friend commented about her bare feet in sandals.
She looked down and discovered that her second toe was ‘hitching a ride’ on the big toe. How long had that toe been riding on the other?
She told me she could not say; she’d never noticed it.
If you have hammertoes, you are certainly not alone. Like its siblings— claw toe, mallet toe and curly toe— hammer toe incidence increases with age. It usually affects the second, third or fourth toes. As you probably guessed, it will not go away if ignored.
Two Stages of Hammer Toes.
In the first, the toe is still flexible and you can manipulate and straighten it at the joint. At this stage, we have some conservative options open to us. Once your tendons have become stiff, they can bend the joint out of alignment.
In this second stage, the toe can’t be moved manually. In this case, we may need to consider surgery.
While a hammer toe— which is basically a muscle or tendon imbalance that results in a crooked bone — does not cause pain on its own, it can soon make itself felt with pain or irritation in the shoe, or by causing corns and calluses.
Hammer Toe Treatment Options
We can usually apply conservative treatments as a first option. These might include strategic placement of pads to protect the foot from rubbing against the inside of your shoes. Switching to shoes with a roomy toe space and flat heels could help alleviate the irritation.
If these measures don’t help, there are orthotic (corrective) devices we can place in your shoes. Splints are available as well to align the bent toe.
Sometimes a cortisone injection or nonsteroidal, anti-inflammatory drugs (NSAIDs) will ease the pain and inflammation.
If the condition has progressed to the point where the joint is dislocated or an open sore refuses to heal, we might suggest hammer toe surgery.
There are a few things you can do yourself to manage the problem. One is to wear shoes with a half-inch of space between the tip of your toe and the shoe, and avoid heels higher than 2-3 inches.
Measure new shoes by trying them on the larger of your two feet. (Most people’s feet are not the exact same length.) Wear the socks that you will be wearing with these shoes when you try on new footwear. Don’t buy shoes simply by size; sizes vary from one manufacturer to another.
Try some foot exercises: Use your toes to pick up small objects (like marbles, or pet kibbles). Hold onto the back of a chair and stand tip-toe to stretch the toes. While you’re watching television, place your bare feet on a small towel and use your toes to grip the towel and crumple it.
If you have diabetes or poor circulation, better make an appointment to see us. Hammer toes can be a serious problem for people with these conditions— and a major annoyance for the rest of us.