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Dr. Bob discusses hammertoes and treatment options available.
What's a hammertoe?
A hammertoe occurs when the middle joint of the toe develops an abnormal bend and becomes flexed or bent downward. This results from a muscle imbalance around the toe joints and typically affects the second, third, and fourth toes.
This imbalance causes the toe to bend at one or more joints, ultimately pushing the middle of the toe upward into a claw-like position.
Unfortunately, a hammertoe causes pain and will not improve without treatment. The sooner it is addressed, the better the outcome and the shorter the recovery period.
What causes a hammer toe?
Although hammer toes are primarily hereditary, they can develop over time as the toe’s tendon is abnormally stretched and pulled. This foot health issue can arise due to several different risk factors, including:
- Trauma or injury to the foot or toe
- Abnormally high arches
- Flat feet
- Weak calf muscles
- Wearing shoes that are too tight, too pointy, or lack arch support.
- Children wearing shoes they have outgrown.
- Strain caused by a bunion as the second toe elevates and becomes bent to make room for the shifting big toe.
- Diseases that affect the bones, muscles, tendons, and ligaments. Arthritis, diabetes, neuromuscular disorders, and stroke can all increase the likelihood of hammertoe.
Flexible hammertoe vs. rigid hammertoe: what’s the difference?
In its early stages, a hammertoe is flexible, meaning the joint can still move and may be straightened manually. At this stage, the tendons and muscles remain supple.
A flexible hammertoe can be uncomfortable and may cause pain; however, since the toe can still move, there are more treatment options available, often including less invasive measures like physical therapy, custom orthotics, or splints.
As the condition progresses, the toe may become rigid. At this stage, the tendons have tightened, and the joint becomes immobile. The toe cannot be straightened manually.
Rigid hammertoe often leads to increased pain and discomfort. Friction between the hammertoe and shoes may also result in further complications like sores, calluses, or corns. Treatment options for rigid hammertoe are more limited and typically require surgery to correct the deformity.
Early intervention in a flexible hammertoe can prevent progression to a rigid hammertoe. Therefore, it’s important to seek medical advice as soon as symptoms first appear.
What are the symptoms of a hammer toe?
The primary symptoms of hammertoe include difficulties with walking and other foot issues, such as blisters, calluses, and sores. Additionally, pain may arise from constant friction over the top of the toe’s main joint.
It may be difficult to fit into some shoes because of the extra space required for the deformed toe. In many cases, there is pain in the ball of the foot over the metatarsals, along with callus formation. This occurs because the toes do not function properly and fail to effectively touch the ground during the gait cycle. Consequently, the ball of the foot endures the brunt of the ground forces, leading to chronic pain.
How is a hammer toe diagnosed?
The first step is a physical evaluation of the toe by Dr. Baravarian. He also takes X-rays to determine the extent of the contracture. An examination of the entire foot allows him to identify the root cause of your hammertoe.
What non-invasive treatment options exist for hammer toes?
When caught early, there are more conservative options available. The goal of early treatment is to accommodate the hammertoe, relieve pain, and prevent the deformity from worsening.
Some options include:
Better footwear
Choose comfortable, properly fitting shoes with a wider toe box that are half an inch longer than your longest toe. Shoes made with Lycra are often a good choice because the material stretches generously around the irregular toe structure. Avoid pointy or narrow shoes, and if you wear high heels, keep the heels to two inches or less.
Toe braces and taping
Certain toe braces and taping techniques can relieve some pressure on the toes while you walk.
Custom orthotics
Custom-molded shoe inserts can redistribute forces through the tendons that control the toe, reducing both pain and the severity of the deformity.
Foot rollers
Dr. Bob can provide you with a therapeutic foot roller to use at home for stretching and massaging the tendons in your foot, alleviating tension and pain.
Anti-inflammatory medication and ice packs
These treatments can help alleviate swelling and reduce pain.
Surgical treatment options for a hammer toe
For more severe hammertoe, Dr. Baravarian resorts to surgical correction to reposition the toe and enhance its function. Correcting hammertoes is a straightforward outpatient procedure with minimal downtime.
Fusing the toe: Ossio non-metal implant system
The best option is to fuse the affected toe, as this minimizes the need for future surgery and reduces the risk of the hammertoe returning.
The Ossio non-metal hammertoe implant system is a next-generation implant developed in collaboration with Dr. Baravarian. The implant is crafted from a material that closely resembles bone and is not detectable on an X-ray. This enables the surgeon to clearly see the fusion site on an X-ray, free from the shadows of titanium that are present with traditional implants.
What further distinguishes the Ossio non-metal implant from other products is that it integrates into the bone and is replaced by the body with the person’s own bone, resulting in excellent fixation strength. It also enables the toe to be positioned straight or at a 10-degree angle for a more natural appearance.
OSSIOfiber® all-natural implant
Dr. Baravarian is proud to offer a groundbreaking non-metal fixation option for hammertoe surgery called OSSIOfiber®. OSSIOfiber is a biodegradable polymer combined with a mineral fiber that gradually integrates into human bone, reinforcing the bone at the healing site.
It is eventually eliminated and replaced by the body’s own bone through natural cellular turnover. Thus, the material not only
Removing the hammer toe deformity
In the most extreme cases, the removal of a small area of bone in the deformity area will decrease pain and limit the need for a surgical waiting period that is found with fusions. Although the toe is not as stable as with a fusion, in certain cases, an arthroplasty is the best option.
View Dr. Bob’s gallery of before and after pictures from hammertoe surgeries here.
What are the benefits of hammertoe surgery?
After surgery, patients can look forward to returning to the activities they love. Pain and discomfort are addressed, and there will be no pain while walking or hiking since the toe joints will no longer experience pressure or rub against the inside of shoes.
This results in better health, which in turn enables patients to live active lives. They will no longer feel self-conscious about taking their shoes off at the beach and can feel comfortable walking barefoot.
Hammer toe surgery recovery
The procedure to correct a hammer toe takes about one hour. After the surgery, patients wear a walking boot for six weeks to protect the foot during the healing process. Following that, you will experience a decline in swelling for around two more weeks, but you will be able to wear shoes.
Why choose Dr. Bob Baravarian for hammer toe treatment?
Dr. Bob Baravarian, DPM, has helped transform the treatment of hammer toes over the past two decades. He takes pride in providing the most advanced diagnostic technology and treatment options available.
Dr. Bob presents his revolutionary approach to the surgical treatment of hammertoes and related foot deformities. He utilizes a screw or absorbable pin to promote rapid healing and early weight-bearing. There is often no need for a pin to protrude from the toe post-surgery, which can be a source of infection and rigid fixation. Dr. Baravarian’s goal is to ensure you are back on your feet in the least invasive and fastest way possible.
Dr. Bob Baravarian is conveniently located in Los Angeles, near Cedars-Sinai Medical Center, providing expert foot and ankle care for patients throughout Southern California.
Hammer Toe and Hammer Toe Surgery FAQs
What are mallet toe and claw toe?
Similar to hammertoe, mallet toe and claw toe are deformities that cause the toes to bend downward. Unlike hammertoe, mallet toe affects the joint closest to the toenail, while claw toe involves the joint nearest to the ball of the foot. Both mallet toe and claw toe share many of the same causes, symptoms, and treatment methods as hammertoe.
Are hammertoes the same as corns?
No, but corns often develop alongside hammertoe. Corns appear as tough bumps of skin that form over a joint in the foot or toe. They are essentially layers of skin that have developed in response to the joint rubbing against the inside of your shoe.
How is hammertoe treated?
Mild and moderate cases of hammertoe are typically treated conservatively with orthotic inserts and well-fitting shoes that allow for comfortable movement and encourage healing.
How does hammertoe surgery affect performance in sports, especially football and running?
Hammertoe correction surgery genuinely enhances sports performance, particularly in grip and foot strength.
Can hammertoe be treated with surgery?
Severe hammertoes may be treated with surgery. Surgery can reduce pain and improve the appearance and functionality of the toes. Hammertoe correction surgery is an outpatient procedure with very little downtime.
What can I expect during my recovery from hammertoe surgery?
Most patients can walk with the aid of crutches and a special boot provided by their doctor. Pain and swelling are typical for about a week after surgery. Your doctor can prescribe medication to help manage the pain. Be sure to get plenty of rest and keep your foot elevated while sitting or lying down.
After hammer toe surgery:
- 2-3 weeks: Stitches may be removed.
- 4-6 weeks: Any surgical pins that were used may be removed.
- 6 weeks: Average recovery time. Some people may return to their normal routine as soon as 2 weeks,while others may take up to 3 months.Generally, the pinky toe is the quickest to recover, while the second toe takes the longest.
Can a hammertoe come back after surgery?
Some cases of hammertoe may relapse after surgical correction. Depending on the type of surgery and your aftercare routine, the deformity might return. If your toe starts curling again and you experience discomfort, consult your foot and ankle specialist.
