Hammer Toe

Your forefoot is made up of 4 phalanges (smaller toes) and 1 hallux (big toe). Your phalanges have 3 bones as well as 3 joints (MTP - nearest base of foot, PIP joint - middle, and DIP joint - tip of toe); your big toe only has 2 bones and joints. Your midfoot (metatarsal bones) and hindfoot (tarsal bones) make up your foot arches, instep, heel and ankle; these are responsible for weight bearing and propulsion. Your arches contain bones, ligaments, muscles and tendons of your foot, which require a lot of stability and flexibility.

Hammer toe makes your toes bend and look like a hammer. It causes your MTP joint to bend up and your PIP joint to bend down. This normally affects your second toe; however it can affect any of your small toes. It can be flexible (joint has ability to move) or rigid (joint has limited and/or no ability to move). Failure to treat it can breakdown tissues which affect the way you walk and lead to serious toe, foot, knee, or hip ailments, and/or infection. Hammer toe is among the most common toe deformities. Both men and women are at risk; however women are 5 times more likely to experience it than men. Also, the chance of suffering from hammer toe increases by 2 - 20% with age.

Causes

If you have hammer toe your flexor digitorum longus muscle (on bottom of toes) is often stronger than your other muscles; which creates an imbalance (your weaker toe muscles are overpowered). It exerts more tension on your foot which pulls your normal foot arch down - creating a flatter and longer foot.

Inappropriate footwear (short, tight, narrow, pointed, or high heels) puts pressure on your feet and keeps your toes in an unnatural, bent position. Wearing this type of shoe for long periods of time prevents your muscles from straightening your toe even when not wearing shoes. Often corns or calluses (hard growths of dead skin) or bunions (enlargement of bone or tissue on big toe) will develop around these pressure points from rubbing against shoes, which initiates hammer toe.

Conditions from birth, hereditary characteristics or abnormal toe bone lengths Muscle, nerve and joint damage from osteoarthritis, stroke, neuromuscular diseases (multiple sclerosis, Charcot-Marie Tooth disease, cerebral palsy, degenerative disc disease), inflammatory diseases (rheumatoid arthritis, psoriasis) or diabetes, poor blood flow to your feet (peripheral arterial disease)

Previous toe injuries, dislocation of toe joints or poor foot mechanics.

Excessive weight and activity levels

Symptoms

You will often have constant pain in your toe when moving it as a result of corns, calluses, bunions or blisters; generally found on the top, tip or base of your toes. The discomfort from this and cramping in your toes can radiate to your entire foot and lower leg, and can lead to posture and balance changes (affecting the way you walk).

Other hammer toe symptoms:

• Inflammation, redness and swelling in toe joints, synovial membrane (connective tissue and fluid which lines joint cavity), and bursa (fluid filled sac between tendons, ligaments and bones preventing friction)
• Deformed nails
• Infections or ulcers in toes
• Pigment discoloration

Diagnosing Hammer Toe

Your doctor will take your medical history and will examine your foot and toe for any deformities and inflammation (swelling, redness, heat, pain). He/she will analyze your flexibility, stability, and gait (the way you walk). Occasionally an x-ray (check for arthritis or bone and joint inflammation) or blood tests (rule out diseases or infections) may be requested.

Treatment and Prevention

Early diagnosis and proper treatment are important, however hammertoe can be difficult to prevent as symptoms often start long after you¹ve had the condition. The goal is to relieve pain, reduce friction and transfer pressure from your sensitive areas. If your hammertoe is flexible, you can often manually straighten your toe. If your hammertoe is rigid, extra stress at the ball of your foot prevents your toe from straightening; you may require more extensive treatment. Failure to see improvements after conservative treatments may make surgery your only option.

Ultrasound is an excellent tool to reduce pain and inflammation when treating hammer toe. The application of ultrasound over the affected toe and foot area reduces swelling, increases blood flow, decreases pain, relieves tension making muscles and tendons more flexible, minimizes scar tissue, and helps tissues heal more quickly. It can be performed at home easily and safely with a portable ultrasound device.

Other conservative treatments:

1. Properly sized, adjustable, low-heeled footwear provide room and comfort (leave a 1/2 inch space between longest toe and inside of shoe); avoid super-snug stockings, nylons and socks


2. Footwear made out of breathable and flexible materials help prevent against corns, calluses and bunions (avoid vinyl or plastic materials)


3. Gentle foot massage after vigorous activities or long periods of standing help relax tissues; physical therapy, foot manipulation and reflexology are good for severe cases


4. Cushioning or supportive items, such as straps, non-medicated felt pads, moleskin, splints, toe shields or caps, protect and reposition your toe, and relieve pressure pain


5. Exercises that stretch and strengthen your foot muscles and tendons keep your muscles balanced


6. A healthy diet especially if you have diabetes (more prone to poor circulation and lack of feeling in your feet) keeps your body healthy


7. Corrective footwear, orthotics or other foot devices provide support and alignment (check to see if you wear out the soles of your shoes on one side)


8. Soak your toes in alternating warm and cold water baths; gently rub your corns or calluses with a pumice stone or nail file while your feet are in warm water

Toe surgery (tenotomy, tendon transfer, arthroplasty, or arthrodesis) helps to straighten your toe joint in severe cases when the soft tissues in your toes become very stiff and don't move at all. However, surgery is not always effective; it may improve the look of your foot, however there's no guarantee the problem won't come back after surgery.

Recovery from hammer toe can take between 4 weeks - 6 months, depending on the severity of your condition and your commitment to proper rehabilitation. The more dedicated you are with your treatments, the faster you will see successful, long-lasting results.

See Toe Deformities for more detailed information.

Therapeutic Products

Blood Flow Stimulation Therapy

You can help your body repair your plantar fasciitis, heel spur, arch pain or tendon injury by boosting the natural healing process using an Inferno Wrap™. The Inferno Wrap's patented design delivers the most effective Blood Flow Stimulation Therapy you can find. By stimulating the flow of blood to your foot you are increasing the amount of healing oxygen and nutrients to the area. Unfortunately, we need to rest in order to heal and this decreases the blood flow throughout our bodies. Since you can't work your foot without danger of further injury, you need to stimulate the blood flow another way. Our innovative Inferno Wrap™ gives you the best Blood Flow Stimulation Therapy available. The Inferno Wrap™ creates energy waves that stimulate blood flow while you rest by penetrating through the outer layers of your foot. The energy waves reach deep into your foot reducing your pain as they heal the inner tissue.

The Inferno Wrap™ provides effective, non-invasive, non-addictive pain relief with no side effects. By treating your heel spur or plantar fascia in the morning before stepping out of bed, you will warm the area and prepare it for use during the day with less risk on re-injury. When your injury has healed somewhat and it comes time for more aggressive rehabilitation, stretching and activity, Blood Flow Stimultation Therapy warms the tissues in the injured area which increases range of motion and allows for a safer stretch with less risk of reinjury.

Therapeutic Ultrasound

Ultrasound Therapy is also a great tool for pain prevention of heel spurs, plantar fasciitis and tendon injuries, and having a therapeutic ultrasound device at home can be a powerful and convenient treatment tool. If you are suffering from a heel spur or have an injured plantar fascia or are recovering from a tendon injury, using ultrasound on a regular basis before your activity or throughout the day will help relax the area, diminish pain and inflammation, soften scar tissue and contribute greatly to the healing of your injury.

Therapeutic Ultrasound warms and massages your soft tissue giving you three primary benefits. First, it increases blood flow in the treated area which speeds your body's natural healing process. Second, it reduces swelling and edema which are the main sources of pain. Third, ultrasound softens existing scar tissue and minimizes the build up of new scar tissue resulting in reduced pain while healing and greater flexibility once healing is complete.

Eucalyptus...
It's in our Gel!

Ultrasound can also be used to administer therapeutic medicines into the body. This is a process known as phonophoresis. Ultrasound with Phonophoresis is rapidly becoming more popular than Ultrasound Therapy alone.

Peppermint...
It's in our gel too!

Our MendMeShop Lavender Infusion Gel is the only topical therapeutic gel that is also a Phonophoretic Ultrasound Gel. It is made with natural medical ingredients including eucalyptus, peppermint, Bulgarian lavender and menthol. These effective ingredients have anesthetic, anti-inflammatory, analgesic, decongestant, and circulatory stimulant properties. When applied topically and massaged into the skin, MendMeShop Lavender Infusion Gel relieves pain and speeds healing without any side-effects.

Freezie Wrap™ Cold Compression Therapy

Our cold compression wraps work by interrupting and slowing nerve and cell function in your foot. Once blood vessels are damaged they can no longer carry oxygenated blood to the damaged tissue and therefore cells begin to break-down. The deep cold provided by our cold compression wraps slows cell function thereby reducing cellular break-down. Furthermore, because the cold wraps serve to numb the nerves, the wraps also reduce pain!

With the non-migrating gel that holds the cold for your cold therapy, our Freezie Wraps are the best. We have noticed over time that our customers are so fond of our cold wraps that they are frequently coming back and ordering a second one - this way they can cool one while wearing the other. The wraps are becoming very popular with baseball and soccer trainers, and the wraps can be conveniently stored in a cooler for quick application on the field when needed.

Always allow the injured area to return to normal body temperature between hot and cold treatments by waiting 60-90 minutes before applying a different therapy.