Hammer Toes / Clawtoes

A Hammer Toe is essentially a plantarflexion deformity of the proximal interphalangeal joint with the distal interphalangeal joint remaining normal or possibly dorsiflexed. This can occur in any of the three middle toes, with the second digit being the most commonly affected.

Symptoms

• Toes are bent upward (extension) from the joints at the ball of the foot.
• Toes are bent downward (flexion) at the middle joints toward the sole of your shoe.
• Sometimes toes are bent downward at the top joints, curling under the foot.
• Corns may develop over the top of the toe, or under the ball of the foot due to pressure and / or friction.

Evaluation

If you have symptoms associated with clawtoes, it is important to see your foot specialist for an evaluation. You may require certain tests to rule out neurological disorders that can be responsible for weakening your foot muscles, thus creating imbalances that can bend your toes at unnatural angles. Trauma and inflammation can also cause a clawtoe deformities.

Treatment

Claw-toe deformities are usually flexible at first, but will gradually harden into place over time. If you address clawtoes in the early stages, your specialist may recommend an orthotic device to hold your toes in the correct position.

Additional advice:

• Wear shoes with soft, roomy toe boxes and avoid tight fitting shoes and high-heels.
• Use your hands to stretch your toes and toe joints toward their normal positions.
• Exercise your toes by using them to pick up marbles or crumple a towel laid flat on the floor.

If you have more advanced claw toes and they are fixed in position:

• A special pad can redistribute your weight and deflect pressure from the ball of the foot.
• Try “extra depth” shoes that have an extra roomy toe box.
• Ask a shoe repair shop to stretch a small pocket in the toe box of your shoe to accommodate the existing deformity.
• Orthotic management.