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Hammer Toes

If your toes appear crooked or misshaped you may be a patient of hammertoes. Having the toes bent can cause muscles to shorten causing the hammertoe deformity and pain. Patients may feel pressure against the shoe and under the metatarsal head, particularly the second toe, which is often caused by the retrograde pressure on the big toe.

A hammer toe is a toe that is contracted at the PIP joint (middle joint in the toe), and can lead to severe pressure and pain. Ligaments and tendons that have tightened cause the toe’s joints to curl downwards. Hammer toes may occur in any toe, except the big toe. There is often discomfort at the top part of the toe that is rubbing against the shoe.

Hammer toes can be caused by improperly fitted shoes or a dropped metatarsal head. Some other causes are arthritis, diabetes, neuro-muscular disease, polio or trauma. They can also be caused due to muscular imbalances that cause the ligaments and tendons to become unnaturally tight.

Hammer toes are classified based on the mobility of the toe joints. There are two types – flexible and rigid. In a flexible hammer toe, the joint has the ability to move. This type of hammer toe can be straightened manually. Movement is very limited and can be extremely painful. This sometimes causes foot movement to become restricted leading to extra stress at the ball-of-the-foot, and possibly causing pain and the development of corns and calluses.

To treat a hammer toe, first push up on the plantar surface of the metatarsal head and see if the toe straightens out. If it does, then an orthotic insole could correct the problem, usually with a metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotic insoles are required post-surgically.

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