Hammer Toe Treatment Physiotherapy

Hammer ToeOverview

Hammer toes is a painful deformity wherein a hammertoes toe bends unnaturally. Hammertoe can develop on any of the toes, but generally affects the middle three and, most often, the second toe. When unusual stress is applied over a period of years, the joints and tendons of your foot can cease to function in a balanced manner and toes, in an effort to compensate, can begin to bend into the hammertoe shape. Hammertoes tend to run in families.

Causes

Footwear can contribute significantly to the development of hammertoes. Shoes that are too small force your toes into a curled position. Over time, your toe tendons adjust to this positioning, causing your toe or toes to hold a hammered shape. Athletes may be especially susceptible, because of the increased forces on the toes from shoes that are too small or tight. Heel elevation in footwear is also problematic, as it causes your toes to be pushed into the shoe?s toe box. Heel elevation additionally contributes to muscle imbalance. A common example of this is when your Achilles tendon-the tendon at the back of your leg that attaches your calf muscles to your heel bone-is too tight, causing the tendons on the top of your foot that attach to your toes to work too hard and hold your toes in an unnatural, elevated position.

Hammer ToeSymptoms

People who have painful hammertoes visit their podiatrist because their affected toe is either rubbing on the end their shoe (signaling a contracted flexor tendon), rubbing on the top of their shoe (signaling a contracted extensor tendon), or rubbing on another toe and causing a painful buildup of thick skin, known as a corn.

Diagnosis

Some questions your doctor may ask of you include, when did you first begin having foot problems? How much pain are your feet or toes causing you? Where is the pain located? What, if anything, seems to improve your symptoms? What, if anything, appears to worsen your symptoms? What kind of shoes do you normally wear? Your doctor can diagnose hammertoe or mallet toe by examining your foot. Your doctor may also order X-rays to further evaluate the bones and joints of your feet and toes.

Non Surgical Treatment

To keep your hammertoes more comfortable, start by replacing your tight, narrow, pointy shoes with those that have plenty of room in the toes. Skip the high heels in favor of low-heeled shoes to take the pressure off your toes. You should have at least one-half inch between your longest toe and the tip of your shoe. If you don't want to go out and buy new shoes, see if your local shoe repair shop can stretch your shoes to make the toe area more accommodating to your hammertoe.

Surgical Treatment

Surgery is the approach that is often necessary to correct hammertoe that fails to respond to nonsurgical management. Surgery is appropriate when the muscles and tendons involved in a hammertoe problem have become so tight that the joints are rigid, misaligned and unmovable. There are a number of surgical techniques for dealing with the complex range of joint, bone, muscle, tendon and ligament abnormalities that define each hammertoe's make-up. To correct a hammertoe deformity, the surgeon's goal is to restore the normal alignment of the toe joint, relieving the pressure that led to the hammertoe's development (this should also relieve the pain, as well). To do this, he or she may remove part of the boney structure that creates a prominence at the top of the joint. Tighten or loosen the muscles, tendons and ligaments around the toe joints. Realign the toe bones by cutting one or more and shifting their position, realigning muscles, tendons and ligaments accordingly. Use screws, wires or plates to hold the joint surfaces together until they heal. Reconstruct a badly damaged joint or replace it with an artificial implant.

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