What is a hammertoe?
A hammertoe occurs when the muscles and tendons around your toe joint become imbalanced. This can cause your middle toe joint to buckle or become rigid. Over time, your toe may curl or it may rise up and overlap with another toe. Most hammertoes happen in the middle three toes. The most common is the second toe and often accompanies a bunion as the big toe crosses under the second toe.
Hammertoes can be flexible or rigid. If you can still move your toe at the joint, it is considered flexible. Rigid hammertoes have fewer treatment options and often need surgery.
Hammertoes can be caused by shoes that don't fit properly or a trauma to the toe. Bunions can also cause a hammertoe. Women are more likely than men to develop hammertoes, as are people whose second toe is longer than their big toe.
Hammertoes are progressive—they don't go away by themselves and they usually get worse over time. Some hammertoes progress more quickly than others. If you think you have a hammertoe we recommend having it evaluated by our doctors before it begins to cause problems.
What are the symptoms of a hammertoe?
A hammertoe looks bent in an abnormal way, either buckled up in the middle or bent to one side. It can also rise and overlap with an adjacent toe. Hammertoes can cause other symptoms such as:
- corns, blisters, or calluses where your toes rub against your shoes.
- pain when you walk on the bottom ball of your foot (this is called metatarsalgia).
- stiffness in the toe joint that gets worse with time.
If you have a hammertoe, we recommend seeing our doctors before it causes pain or symptoms.
Can hammertoes be prevented?
Some people are more prone to hammertoes than others, but choosing shoes carefully can prevent them or prevent them from getting worse. Tight, pointy shoes squeeze and put pressure on the toes, which can lead to a muscle or tendon imbalance. High heels add pressure to the toes and make your foot even more prone to a deformity.
Choose shoes with a wide toe box and make sure that there is about a half an inch of space between your longest toe and the tip of the shoe. This will also help prevent bunions, which can lead to hammertoes as described above.
How are hammertoes diagnosed?
We will diagnose your hammertoe with a foot exam and a standing X-ray. Once we have evaluated your hammertoe, a treatment plan can be developed that is suited to your needs.
How are hammertoes treated?
Your treatment will depend on the severity of your hammertoe and other factors such as your age and activity level.
For hammertoes that are flexible, we may recommend conservative treatments such as:
- shoes with a roomier toe box.
- padding in the shoe or on your toe to accommodate the deformity.
- orthotics to rebalance the mechanics of your feet and alleviate symptoms.
Surgical Treatment of Hammertoes at Foot Associates of New York
If your hammertoe has become rigid and painful, we may recommend surgery. We will also evaluate your foot for bunions or other deformities that need correction at the same time. We use several surgical techniques with specially designed fixation devices to stabilize your toe and achieve maximal correction without recurrence. Usually there is no need for external pins.
In selecting the procedure or combination of procedures for your foot, we take into consideration the severity of the hammertoe, your activity level, and your goals for your surgery.
Every foot surgery takes place in an ambulatory surgery suite at NewYork-Presbyterian—the top-rated hospital in New York City—with a team of expert anesthesiologists and nurses who work closely with our foot surgeons. Your procedure will be pain-free, performed under sedation with local anesthesia. Our unique pain protocol, involving both anti-inflammatory and pain medications, will assure you of a comfortable recovery.
The length of your recovery will depend on the procedure or procedures performed. Our goal is to have you bear weight immediately after surgery and begin a progressive return to full activity in five or six weeks.
We will schedule a follow up appointment about ten days after the surgery and will take an X-ray to monitor your recovery. We will continue to monitor your recovery over the next days and weeks. All patients are given our cell numbers and we are available 24/7 until your recovery is complete.