Advice on Foot Care

Tendon imbalance over time will result in the gradual pull of the toes up into a contracted position. Tendon imbalance is generally due to faulty foot mechanics and may be associated with a high or low arch foot. With a high or low arch foot, the pull of the tendons on the top of the foot will not equal the pull of the tendons on the bottom of the foot. This unequal pull will cause the gradual rise of the toes. As the toe rises, it presses down on the metatarsal head (as seen in the picture above) which can result in pressure on the bottom of the foot. It may take decades for the hammertoes to develop.  Small shoes or high heels can contribute to the development of hammertoes, but in most cases simply rub the tops of the toes and cause irritation and corns.

There are not many treatment options for hammertoes and in most cases, simple padding can keep the toes comfortable. Some pads are designed to keep the pressure off of the top of the toes where corns may develop. Other pads are designed to help straighten the toes. Some pads can be placed between the toes and help space the toes and prevent rubbing. Another important step is to change to a wider pair of shoes, with more depth in the toe box. Shoes which are too tight and too narrow will cause rubbing and irritation. Some individuals will have overpronation (feet which roll in) and may benefit from a pair of custom made or prefabricated orthotics.

When conservative therapies fail, surgery may be necessary. To straighten the toe, the surgery generally involves removing the small joint in the toe or fusing it, along with releasing any tight ligaments or capsule which may contribute to the problem. Many times a pin is placed across the joint during the healing process, in some cases the pins are absorbable.

More on hammertoes.
More on treatments for hammertoes.
More on hammertoe surgery.

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