By Rehan Iqbal
If you have a toe that is bent into a strange position, you may have a hammer, claw or mallet toe. What’s the difference? What can you do? In this article, we explore these questions.
All three types of toe deformity usually occur in the four small toes, not in the great toe. They all detract seriously from the appearance of your feet in open-toed shoes, but worse, they all cause quite a bit of discomfort. In addition to causing bent and crooked toes, these maladies may also cause:
Causes of these maladies are also similar and include:
Any or all of these factors may cause imbalance of the tendons, ligaments and muscles that keep your toes straight.
Which Is Which?
Hammer toes bend at the middle joint and point downward toward the floor. This deformity is usually seen in the second toe and is often caused by a bunion.
Claw toes may occur in all four small toes at once. In this deformity, the toes bend upwards at the top joint (where the toes join the foot). The middle and end joints bend downward causing the toes to permanently curl.
Mallet toes bend at the very end joint of the toe. This deformity is most often seen in the second toe, but it can also affect the other three small toes.
What Can You Do?
Try the simplest solutions first. Seek out high quality, well-fitted footwear that provides plenty of support and plenty of room in the toe box. Select shoe inserts and supports that help position your toe correctly. If these home solutions don’t work. Talk with your doctor. He or she may recommend exercises, physical therapy or surgery.
How Can You Avoid These Problems?
Sometimes mallet toes, hammer toes and claw toes are caused by faulty foot structure and/or heredity. Even when this is the case, you can mitigate the damage by making smart lifestyle choices.
Exercise regularly. Muscle weakness and imbalance can cause instability throughout your body and in your feet. Get fifteen or twenty minutes of light to moderate exercise every day to keep your body generally healthy.
Stretch, flex and massage your feet daily to encourage good blood circulation and keep muscles, tendons and ligaments flexible and strong.
Avoid injuring your toes. If you break your toe, jam it or even stub it, you are more susceptible to deformities and complications. Always wear your shoes when walking outside or anywhere foot injury is likely. Put on slippers when you get up at night, and don’t walk around in the dark.
Avoid shoes that are notorious for causing foot damage. Don’t wear high heels or shoes that have pointy toes. Never wear shoes that are too small for you. Always choose shoes that have plenty of room for your toes to lie flat and flex.
Select shoes that offer good support and cushioning to keep your toes properly positioned. Look for:
How To Shop For Shoes
Who Is More Susceptible To Toe Deformity?
Most children are born with perfectly good feet. Years of improper care and improper footwear cause adults to be especially susceptible to these problems. The older you become, the more susceptible you will be.
Women who wear high heeled, tight, narrow shoes can expect to develop toe deformity. Men who wear pointy toed boots are also inviting foot problems.
You are more susceptible to toe deformity if you have a serious chronic condition, such as:
Breaking or spraining your foot or ankle can also make you more susceptible to the development of toe deformities.
Faulty foot structure can make you more susceptible to developing one of these problems. For example, a second toe that exceeds the great toe in length is very likely to develop hammertoe or mallet toe.
Are Complications Likely?
Early on, hammertoes may stay flexible; however, if the tendons continue to tighten and contract, the toe may bend permanently. When this happens, it can be hard to keep the top of the toe from rubbing inside your shoes. This can cause painful sores, calluses and/or corns. These can occur on top of the toe, on the tip of the toe or both.
Foot sores can be a very serious complication. If you get blisters, calluses or sores that do no clear up, be sure to see your doctor. Untreated foot sores can cause infection, osteomyelitis or celulitis. This is especially true if you have a chronic condition, such as peripheral arterial disease or diabetes.
If your toes are severely bent and painful, you may even experience trouble with balance and difficulty walking.
How Does A Foot Doctor Diagnose These Deformities?
Your doctor will talk with you about your general health and symptoms. You may be asked:
Your doctor will also perform a physical exam. Naturally, he or she will pay close attention to your feet. If your doctor determines that there is still some flexibility in your toe joints, you may be able to resolve your problem without resorting to surgery.
To determine whether or not surgery is necessary, your doctor may call for some tests, including:
How Can These Curled-Toe Problems Be Resolved?
One of the pros of developing the habit of exercising and massaging your feet daily is that you are sure to notice as soon as problems begin. As with most health problems, time is of the essence when dealing with hammer, mallet or claw toes. If you make changes and correct problems right away, you probably will not need surgery.
Here are four simple actions you can take on your own:
1. Use over-the-counter (OTC) solutions – In addition to upgrading your footwear, explore the many options in products that are especially designed to support, realign and cushion bent toes. Among them are:
2. Pamper your feet – If you have corns and calluses, take care of them. Soak your feet to soften the hard skin. Use moisturizer daily. Cover calluses and corns with moleskin to protect them from friction in your shoes.
With proper care, these problems will diminish over time. Resist the temptation to cut calluses and corns off. This can cause injury and infection.
3. Address pain – If your feet hurt, elevate them frequently and use OTC pain relievers, such as:
Talk with your doctor to determine which is the best choice for you.
4. Tape your toes – If you have a hammer toe, and the joint is flexible, you may be able to correct it by taping it.
To do this, weave tape under your big toe, over your hammer toe (second toe) and then under the middle toe. This will cause the joint to straighten so that you can wear shoes without rubbing the toe knuckle raw or causing a callus on the toe tip. This is only a temporary fix, though. As soon as you remove the tape, you toe will curl up again.
You can also purchase a toe splint, sling or cap to hold your toe(s) in a normal position.
Exercise your toes several times a day to keep them strong and flexible. Talk with your doctor or a physical therapist for exercise suggestions. Here are a few to get you started:
How Long Do I Have To Exercise My Toes?
Ideally, you should exercise your feet and toes every day of your life. If you do that, and wear good shoes, you probably won’t develop a foot problem. Once you have a toe deformity or foot problem, you must exercise daily to keep your feet flexible. You should begin to see improvement in two or three weeks.
If you exercise your feet diligently, every day, you will continue to see progress. In a matter of weeks, months or years, you may feel that your problem is resolved, but don’t be fooled! If you slack off or neglect your feet, your problem will return.
When Is Surgery Necessary?
If your toe deformity is causing severe pain or limiting your activities, or if your toe joint is permanently frozen, you probably need surgery. If you have been trying faithfully to deal with a hammertoe, claw toe or mallet toe, but exercise and home treatment has had little or no effect in a month’s span, you probably need surgery.
What Happens In Surgery?
If your toe joint is stuck or frozen, your surgeon will operate on the bones. If the toe is still flexible, the surgeon may be able to solve the problem by moving some tendons. This can help release tension so that the toe can straighten out. Sometimes, both bone and joint work are needed.
Your doctor may recommend:
Consider the following when contemplating foot surgery:
Your foot may feel better but look worse after surgery.
There are risks (infection, swelling and pain) involved in any surgery.
Surgery may not permanently solve your problem. It may simply develop again.
If you don’t take care of your feet by wearing proper footwear and exercising after surgery, you are very likely to have problems again.
Before you seek out or agree to surgery, be sure to give exercise and supportive footwear a thorough try. Surgery is seldom necessary, and it’s not always successful. You have a far better chance of improving your existing toe problem than correcting an unsuccessful surgery. Discuss the matter thoroughly with your doctor to gain a complete understanding and make an informed decision.