Home Foot Disorders What is a Hammer Toe? Nailing Down the Details

What is a Hammer Toe? Nailing Down the Details

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What is a Hammer Toe Small
By Richard Huber (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
So, what is a hammer toe?

Put simply, a hammer toe (also referred to as a contracted toe) is a deformity of the foot, specifically a joint in the toe, causing the toe to be bent like a hammer.

The deformity is relatively minor, but living with a hammer toe can still be painful and unsightly. It is important that you take steps to correct this foot disorder if it occurs.

In this article, we will explore hammer toes in depth, including causes, symptoms, treatments (surgical and non-surgical), prevention, and so much more.

It is our goal to provide you with enough hammer toe knowledge that you’ll be able to hit the nail on the head when it comes to dealing with your own hammer toe (or preventing one!).

What is a Hammer Toe?

A hammer toe is a deformity of the proximal interphalangeal joint (see image below) that causes the toe to bend or curl downward instead of pointing forward. This deformity usually occurs on the second, third, or fourth toe, but that doesn’t mean the other two are out of the woods. All 5 toes are susceptible to this disorder, it’s just not as common in the big toe and pinky toe.

Proximal Interphalangeal Joints

There are a couple other toe deformities which, similar to a hammer toe, can result in your toe bending abnormally. These disorders are referred to as claw toe and mallet toe. The way to differentiate between the three is by looking at which joint in the toe is bent.

If only the PIP joint is bent, it’s a hammer toe. If only the DIP joints are bent, it’s a mallet toe. If the MTP, PIP, and DIP joints are bent, it’s a claw toe. It’s not always easy to tell the three apart, so if you have an abnormal bend in your toe make sure and get it properly diagnosed by a doctor.

Toe Joints

What Does a Hammer Toe Look Like?

There are many unique bends in a hammer toe and they can look pretty different from one another. Here are two hammer toes side-by-side that don’t look much alike, but both can be categorized as hammer toes.

What Does a Hammer Toe Look Like
By Richard Huber (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

In the first photo, the pinky toe is bent and looks very rigid. This is what most people picture when they hear the term “hammer toe” because it resembles the shape of a hammer. The second photo is more subtle, but you can see the third toe is angled differently than the others. It is pointing down instead of straight out, and it also has a blister or callus on top, most likely from continual rubbing against a shoe.

What Causes a Hammer Toe?

Now that we’ve learned what a hammer toe is, let’s try and nail down the root causes.

Ill-Fitting Shoes

Shoes that do not properly accommodate the toes and that squish the toes into unnatural positions are the prime culprit when it comes to hammer toes. Because women tend to wear high-heeled or other types of ill-fitting shoes, they are more likely to develop hammer toes than men. Shoes that are too tight, too short (lengthwise), or too pointy can cause problems.

Flat Feet or Unusually High Arches

Both flat feet and high arches can make the feet less stable. Instability can cause the toes to contract in unnatural ways, leading to deformities such as hammer toes.

Arthritis

Arthritis can lead to hammer toes because the joints become weaker and are more susceptible to being bent out of shape.

Traumatic Toe Injury

A traumatic toe injury, like a stub, jam, sprain, or break, can lead to a person developing hammer toe because the joints may not heal properly.

Pressure From a Bunion

Oh those nasty bunions! In addition to being unsightly and potentially painful, a bunion can make your big toe turn in at such an exaggerated angle that it forces the rest of your toes out of alignment. We recently wrote an in-depth guide to bunions if you think you may have one (or want to learn how to prevent one).

Is a Hammer Toe Hereditary?

Technically, no, a hammer toe is not hereditary. I say technically because certain foot types that can lead to instability are hereditary (like the aforementioned flat feet and high arches). Don’t be afraid to ask your older family members how they’re foot health is every once in a while. And if you find that you have similar feet to someone in your family, pay close attention to any foot disorders they get as they age. There’s probably a good chance that you inherited whatever led to that disorder and you should take the proper precautions to prevent it.

What Does a Hammer Toe Feel Like?

A person with a hammer toe may experience pain when walking, or even have difficulty trying to walk. They may lose mobility in their toes or have difficulty doing things like wiggling or stretching the toes out. Corns, calluses, or blisters can result from the top of the toe constantly rubbing against the shoe. The affected toe may become red or swollen. The ball of the foot under the hammer toe may experience discomfort when walking.

According to WebMD, there are flexible hammer toes and rigid hammer toes.

Flexible Hammer Toe

A flexible hammer toe can still be moved at the joint. That means it’s an earlier, milder case and you may still be able to take non-surgical steps to resolve the problem.

Rigid Hammer Toe

A rigid hammer toe is when the toe is locked in to the abnormal position and can no longer be moved. It is at this stage that surgery may be the only option.

Hammer Toe Treatment Options

There are two routes you can take to treat a hammer toe: surgical and non-surgical. Most people, I assume, would prefer the non-surgical route. It’s less expensive and less invasive, and you always want to avoid surgery if you can. But this all depends on how long you’ve had the deformity and what state it’s in. It is probably best to talk to a doctor to determine which course of action you should take. But, we’ll go through some of the options below and you can decide.

Hammer Toe Treatment Without Surgery

There are several, non-surgical methods to help reduce the pain associated with a hammer toe and to keep it from becoming worse. If the hammer toe deformity is minor enough (still in it’s flexible state), then these methods may actually correct the issue.

Hammer Toe Shoes

When looking for shoes to accommodate a hammer toe, you won’t find much in the way of high-fashion. It’s function over form, which is to be expected I guess. But they aren’t all terrible! A comfortable shoe for hammer toe sufferers should fit your foot well, have plenty of room in the toe-box (extra depth, specifically), provide adequate arch support, and have sufficient padding under the ball of the foot.

We recommend the Orthofeet brand. Orthofeet makes decent looking, and more importantly, well performing shoes for women, and shoes for men. They make orthotic dress shoes, athletic shoes, sandals, boots, and even slippers.



Hammer Toe Exercises, Stretches, and Mobilization

There are several exercises and stretches you can do to increase mobility in your toes and hopefully loosen up the joints and corresponding tendons that have caused the hammer toe deformity. Two popular exercise suggestions kept popping up in our research on the topic.

  1. Put a towel under your bare foot while sitting down and use your toes to crumple it up. Stretch the towel back out and repeat the process.
  2. Put marbles down on the floor and use your toes to pick them up and put them back down again.

These exercises both accomplish the same thing, which is flexing and relaxing your toes, and stretching them out to help increase mobility.

You can also manually stretch the toes on a regular basis to help increase mobility. In this video by natural sports podiatrist Dr. Ray McClanahan DPM, he demonstrates his favorite stretches for treating hammer toes.

If you do end up exercising and/or stretching your toes, it’s important to do it regularly. Develop a daily routine that allows you to work the toes at least once per day, but hopefully more often. Stretch when you wake up, during your lunch break, when you get home at night, or even put a towel under your desk at work and crumple it up during the day. Consistency will pay off when it comes to hammer toe exercises and stretches.

Hammer Toe Splints

Hammer Toe SplintsIn the early stages of a hammer toe, splints can be used to keep the toe in its natural place. But, this treatment becomes ineffective if the hammer toe is allowed to go unchecked. There are a few splints we recommend that may help realign your hammer toe.

  1. Profoot Toe Straight – This is a small, cushioned cloth wrap that you can use to wrap your hammer toe to it’s (hopefully) straight neighbor toe to help straighten it over time. The wrap also provides rubbing relief if your toe rubs against your shoe.
  2. Gel Toe Separator Splint – This item splints together your first three toes, with a comfortable, breathable gel pad. Of course if your hammer toe is on number 4 or 5 this item won’t work.

Hammer Toe Pads & Cushions

Hammer Toe Pads and CushionsPads and cushions help to prevent pain and irritation caused by a hammer toe that is pointing downward and rubbing against your shoe. They also relieve pain or stress on the ball of the foot.

  1. Dr. Frederick’s Hammer Toe Cushion – Place the loop around your toe with the pad underneath any toes that are causing you discomfort. The soft gel pad provides relief for pain caused while walking with a hammer toe.
  2. PediFix Felt Hammer Toe Crest Cushion – Similar to the Dr. Frederick’s model, but made with felt (how nice does that sound on your toes??). This item is machine washable if you’re concerned about it getting dirty or smelly.

Hammer Toe Caps

Hammer Toe CapsToe caps are more for prevention of rubbing and avoiding calluses or blisters. That being said, if your hammer toe is still in the flexible stage you may see some straightening effects from the minimal pressure applied by these caps.

  1. Gel Toe Cap & Protector – These caps slip over your toe and protect it from rubbing on your shoe or your other toes.
  2. Fabric Sleeve Protectors With Gel Lining – These caps are similar to the above but the exterior is fabric and may slide more easily inside your socks.

Hammer Toe Separators & Stretchers

  1. YogaToesHammer Toe Separators & Stretchers – There is only one recommended product in this category because it’s our absolute favorite in terms of toe maintenance and general foot disorder prevention. Toe separators and stretchers can work wonders in terms of realignment, even in the case of hammer toes.

Hammer Toe Surgery

If other methods of treatment didn’t work for you, or you just want to get rid of a hammer toe quickly, then surgery is an option. By all accounts it is a relatively minor surgery that is done with local anesthesia, and you should be able to go home the same day. The surgeon may choose to correct the hammer toe by getting rid of a part of the bone and using pins to help make the toe realign (the pins will be removed a few weeks after surgery). The surgeon can also choose to reroute the tendon in the toe, which helps encourage the toe to realign.

What is a Hammer Toe Surgery
Hammer Toe that has been corrected by surgery, with the pin still in the toe.(By Richard Huber (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons)
If you aren’t squeamish and want to watch a hammer toe surgery, I found one on YouTube.

Hammer Toe Surgery Recovery

Recovery times will vary depending on the patient and the severity of the surgery. Post-surgery symptoms (stiffness, redness, swelling) can persist for weeks or even months, but will get better with time. We found this excellent guide to hammer toe surgery recovery that will walk you through the process better than we could.

Hammer Toe Surgery Cost

The cost for a hammer toe surgery will vary depending on many factors, including your location and the severity of your deformity. However, sites like HealthCareBlueBook provide a “Fair Price” that you should reasonably expect to pay for a medical procedure. For a hammer toe surgery, they estimate a cost of $4,265. Take these costs with a grain of salt and speak to your doctor about options.

Hammer Toe Surgery Cost - Health Care Blue Book
“Fair Price” for a Hammer Toe Surgery – Total: $4,265 | Source: HealthCareBlueBook

How Do You Prevent Hammer Toes?

Prevention is Better Than Cure

Prevention of hammer toes is relatively easy. If you treat your toes well and provide preventative maintenance, you can save yourself a lot of hassle (and potentially money) down the road. Preventative measures include:

  • Wear sensible shoes that give your toes ample space and that don’t squish them together.
  • Avoid wearing high-heeled shoes for extended periods of time.
  • Use orthopedic shoes or inserts to help with arch support.
  • Do simple exercises regularly, like manipulating an object with your toes, to help keep the toe muscles loose.
  • Utilize toe spacers or stretchers like YogaToes on a regular basis! We really want to hammer this point home (pun intended). Proper foot maintenance can prevent any number of foot disorders. YogaToes are an easy, and super effective measure anyone can take.

Conclusion

A hammer toe can range in severity from relatively minor to enormous discomfort if left untreated. It’s important that you take steps to treat a hammer toe at the first signs of a deformity, or follow proper care and maintenance methods to prevent one from ever occurring. When dealing with a hammer toe, it is important that you take immediate and consistent steps to correct it before it becomes worse.

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