Hammer Toes, Claw Toes, Mallet Toes, Curly Toes & Webbed Toes are all toe deformities. Most of these conditions are caused by poorly fitting, tight shoes combined with a muscle imbalance. Two main muscles work together to bend and straighten the toes. When shoes are too tight and short or heels are too high and do not fit properly, the toe is forced to stay bent for long periods of time and the muscles and tendons shorten and contract. The toe cannot straighten out and it becomes permanently bent.
These conditions can become extremely painful especially while walking due to the toe or toes pressing and rubbing against the shoe. Each of the above conditions involve a different toe joint or combination of joints. These deformities are called ‘deformities of the lesser toes’ because they usually affect all toes except the big (great) toe.
The foot is a highly mechanical apparatus made of many bones, tendons, ligaments and other coordinated structures. The foot carries the entire weight of the body, and it propels us forward to stand, walk and run. Several common foot conditions–deformities of the toes–can cause extreme pain and loss of the function of the feet.
HAMMER TOE:
A hammer toe is a toe that is curled because of a bend in the middle joint of a toe. It is caused by shoes that don’t fit properly or higher heels that force the foot down and squishes the toes against the shoe increasing the pressure and bends the toe. It is a deformity of the second, third or fourth toe. The toe is bent in the middle so that it resembles a hammer. Pain and a toe that looks odd are the first symptoms of hammer, claw and mallet toes.
Initially, a hammer toe is flexible and can be treated and corrected with simple measures, but if it is left untreated, the toe becomes fixed and will require surgery to correct. Corns or calluses form on the top of the middle joint or on the tip of the impaired toe and causes pain when the calluses rub against the shoe. Women have more of these toe problems than men because of the type of shoes they wear, like high heels.
To keep from getting hammer toes, shoes should always be one-half inch longer than your longest toe. Sometimes the longest toe is the second toe, not the big toe. Avoid wearing tight, narrow, high-heeled shoes. If the toe is already bent, find a shoe with a deep toe box that will allow room for the hammer toe. Sometimes a shoe repair shop can stretch the toe box so it bulges out around the hammer toe to give it room. Sandals may also help so nothing rubs or pinches the affected toe or toes.
Home remedies include straps, cushions and corn pads that are available to relieve symptoms, but if you have diabetes, poor circulation or a lack of feeling in your feet, be sure to consult your physician before self-treating. If all other methods fail, a hammer toe can be corrected by surgery. It is done as an outpatient with a local anesthetic. After surgery there is usually some stiffness, swelling and redness, and the toe may be slightly longer or shorter than before.
CLAW TOE:
While most toe deformities are a result of poorly fitting shoes, a claw toe is caused by muscle imbalance, and the imbalance may be due to conditions like rheumatoid arthritis, polio, neuromuscular disorders, a stroke or other conditions. A claw toe is a toe that is contracted at the middle and end joints and can occur in any toe except the big toe. It can lead to severe pain and pressure. The toe curls downward due to tendons and ligaments that have tightened. The top part of the toe rubs against the shoe causing discomfort at the top and the end of the toe. The toe is also pressed against the bottom of the shoe causing pain.
There are two types of claw toes, and they are classified based on the movement of the toe joints. In flexible claw toe, the joint has the ability to move. This type of claw toe can be straightened manually. A rigid claw toe is very limited in movement and any movement at all can cause extreme pain. Foot movement becomes restricted and extra stress is put on the ball of the foot and that causes more pain and the development of corns and calluses.
The most important step in treating claw toe is to change the type of shoe worn. Make sure the shoe has a toe box that is high and broad and can accommodate the claw toes so there is less friction against the toes.
Other home remedies include using products designed to relieve claw toes, like toe crests and hammer toe splints. These devices help hold the claw toe down and provides relief to the forefoot. Gel toe shields and gel toe caps can help eliminate friction between the shoe and the toe. If these remedies do not offer relief, consult your podiatrist. Surgery may be suggested to correct the alignment of the toe or replacement of a joint.
MALLET TOE:
Mallet toe results when the joint at the end of the toe cannot straighten out. The end of the toe rubs against the top of the shoe leading to pain and the development of a corn. The tip of the toe often turns downward against the shoe causing great discomfort and pressure.
Arthritis can lead to mallet toes as well as poorly fitting footwear worn for long periods of time. Ignoring the problem can lead to the breakdown of tissue and infection. Again, home remedies can help relieve pressure, reduce friction and transfer weight from the sensitive areas.
Symptoms of mallet toe can include the obvious mallet-shaped deformity of the toe, changes in gait and balance, redness and swelling on and around the toe, corns, calluses, infection, and ulcers in patients with diabetes who have decreased feeling in the foot.
Shoes with a high and broad toe area are recommended to prevent further irritation. Other treatments include gel toe caps and gel toe shields and toe crests. Also, using a pumice stone on calluses regularly can help. Wearing shoes with a roomy toe box at least 1/2 inch longer than the longest toe, and wearing a cushioned pad over the tip of the toe and orthotics in the shoes are also beneficial. Avoid wearing high heels. Corn and callus pads and strengthening the toe muscles with exercises will help. Surgery may be required to realign the toe.
CURLY TOE:
Curly toe involves malrotation of one or more toes. The malrotation usually involves the 4th and 5th toes and they are flexed downward and twisted underneath the adjacent toe. Curly toe is a common disorder in infants and children. If there are no symptoms, no treatment is needed but if the condition is severe and causes irritation with shoe wearing, surgery may be necessary. Often the deformity is congenital and bilateral (both feet are affected).
WEBBED TOES (Syndactyly):
Webbed toes are quite common and rarely cause problems. Unlike webbing of the fingers which require surgical separation to obtain finer hand functions, webbed toes do not need treatment.
