Hammertoes are at the top of the list when it comes to patient complaints.
They can be annoying when walking or just when you are looking at them. Patients often tell me that they cannot wear certain shoes because their hammertoes are being pressed upon and are in pain. The usual culprit is the 2nd toe since in the majority of patients it is the longest. In this blog we are going to discuss the causes of hammertoes and how we treat it at Advanced Podiatry.
There are many causes of a hammertoe and improper fitting shoes is one of them.
When you have your toes in tight shoes they automatically pull back in order to fit in the shoes. When the digits scrunch up the muscles of the digits contract as well and therefore become accustomed to this deformity. The antagonistic muscles of the digits therefore weaken and the toes remain contracted even in a relaxed state.
Flat feet or decreased arches also causes contracting of the digits due to simple foot structure problems. When one flattens out their arches the body reacts to this motion by contracting the digits of both feet. This is to aid in stability of the foot and ankle. This process is called flexor stabilization. People with chronic flat foot syndrome have a higher propensity for hammertoes since the body is constantly trying to stabilize the lower extremity by gripping the ground with the toes. The toes thus stay contracted since over time the muscles adapt to this deformity and accepts it as a normal occurrence.
Arthritis can also be another cause of hammertoes since the joints have a large effect on positioning of the toes. Patients who have osteoarthritis or rheumatoid arthritis know that their joints deviate away from the normal position over time and sometimes these variations can be painful. The joint therefore moves abnormally and contracts due to the muscles pulling in an improper way. Osteoarthritis is a difficult disease but can be treated effectively for the majority of patients.
The first step in correction of the hammertoe is always conservative therapy. The first visit you will probably be advised to wear a splint for the effected toes. This toe splint either pads the toes so they do not press as hard in the shoe or they aid in straightening the toe so that the hammertoe is less pronounced. Both of these options are very effective and should always be utilized initially. We can use the strap and pad in conjunction with a custom orthotic (inserts) device which will help align and support the feet so that the arch will not fall and the pull of the muscles will be normalized. With the support of a custom orthotic (insert) we can prevent or delay many problems from occurring simply because we are keeping the foot in its proper position.
When conservative therapy fails then our minds will turn towards surgical correction of the problem. With a hammertoe the doctor needs to assess whether a soft tissue correction or a boney correction is needed for the patient. Through the physical exam the surgeon will assess the unique structure of the patient and determine a proper course. At Advanced Podiatry we utilize the latest surgical techniques and therefore we can help alleviate pain with a minimalistic approach. Minimally invasive surgery for hammertoe correction is highly effective and can be a viable option for most patients. With minimal invasive surgery we correct the hammertoe through tiny openings in the skin and this approach decreases post-op pain and recovery time for the patient. The procedure for correction of a hammertoe can be a combination of tendon releases and smoothing out the boney structure of the digit. The surgeon will discuss the options for your particular case and the most non-invasive method will be utilized be it soft tissue or bone burring. Patients who have this procedure completed are able to walk out of the surgery and recovery typically takes between 3-5 weeks. During the recovery period the patient is able to shower and walk on the foot as tolerated. The doctor will determine what activities the patient can undertake while recovering from the procedure. The patients who have this done are extremely satisfied and are happy about the easy recovery period.
Hammertoe treatment is very common at Advanced Podiatry and we want you to live a happy and pain free life. We listen to you and understand your busy lifestyle and therefore tailor our treatment to effectively reduce your pain but also treat it properly. The needs of our patients is very important and we want to preserve your active lifestyle as best as possible. Please make an appointment today and talk with the doctors of Advanced Podiatry about correcting your hammertoe today.
Dr. Jairo Cruz Jr.