Condition Spotlight: Hammertoes

image of a foot where a toe has been replaced by the head of a hammer

What are Hammertoes?

Let’s start with the basics.  Your little toes contain 3 bones and 2 joints which allow them to bend and function.

A hammer toe is a digital deformity where the middle joint of your toe bends or curls downwards, instead of pointing straight. The name of the joint that is affected in a hammer toe is called the ‘proximal interphalangeal joint’. That’s a mouthful isn’t it?!

Due to this bend in the joint, the toe resembles a hammer…hence the name “hammer toe”!

Hammer toes can affect any toe on your foot, however the second or third toe is most commonly affected!


What Causes Hammertoes?

In some cases, a hammer toe may be present at birth, however, they often develop over time.  Footwear plays a significant role in the development of a hammertoe, although trauma and weak tendons are also common causes of toe deformity.

Some of the common causes of hammertoes are:

  • Muscle or tendon changes

There are tendons in your toes that enable them to move.  Overtime, weakness of the muscles and tendons in your leg and foot can result in the abnormal bending of the toe.

  • Tight or ill fitting footwear

One of the most common causes of a hammer toe is ill fitting or tight footwear.  If your toes are forced into a tight pair of shoes for a prolonged period, the toe positioning can be permanently changed, resulting in a hammer toe deformity.

  • Genetics

If you have a family history of hammertoes you are likely to inherit one – thanks Mum & Dad!

  • Trauma

If you’ve previously had an injury in which you stub, jam or break a toe this can make it more likely for that digit to develop hammertoe.

  • Bunions

When the big toe is progressing towards the other toes, as is the case with a bunion, the lesser digits often have to essentially move out of the way.  This can cause digital deformities, such as hammer toes, in any of these digits, as the structure of the forefoot is changing and they are required to adapt.


Who Can Get Hammertoes?

A hammertoe can affect anyone! However, if you have a family history of hammertoes you are likely to inherit one.  Females also have a higher chance of developing a hammertoe, due to ill fitting footwear such as heels or pointed shoes.

Those who have a 2nd toe which is longer than their big toe are also more likely to develop a hammer toe due to repetitive trauma in footwear.


What Other Deformities Can Occur in the Toes?

Along with hammer toes, other deformities can occur in the toes. These include:

  • Mallet toes – A bend through the end joint near the toenail, called the distal interphalangeal joint.
  • Clawed Toes – A bend through both the middle and end joints of the toe – the proximal and distal interphalangeal joints.

How Are Hammertoes Diagnosed?

A hammertoe can be easily diagnosed by a thorough examination of your feet.  This includes testing the range of motion to determine whether the joint is rigid or flexible and observing for any notable swelling which can be suggestive of capsulitis.

Taking not of callus or corns on the top or bottom of the toe also gives us an indication of where there is too much pressure.

We may also request a series of x-rays to rule out any bone pathologies.

Thorough history taking is very important – we make sure to take note of any previous trauma , diabetes, inflammatory arthritis or neuromuscular disorders.

As podiatrists, we will always conduct a footwear assessment to ensure your shoes aren’t the cause of the issue, or causing any excessive rubbing on your hammertoe.

Finally, it is very important for us to take note of the reason you may be attending for treatment of your hammertoe.  Whether that be pain or the overall appearance of your toe.


How Are Hammertoes Treated?

Treatment will vary according to the severity of your hammertoes, however, we can create toe props to redistribute pressure and alleviate any associated symptoms.

If you’re getting a build up of callus or corn as a result of your hammertoe, we can debride and manage these to prevent them from becoming painful.

Conservative treatment is always the first line of treatment and may entail digital pads, footwear modification and orthotics.

In cases that cannot be managed conservatively, surgical intervention may be required.  This is often minimally invasive and involves bony or soft tissue correction carried out through a small incision into the toe. The main goal of surgical correction is to correct the positioning of the toe and achieve a functional toe.

  • Footwear modification – It is important to ensure that the shoes you wear are the correct size in length, width, and depth.  Your shoes should be wide, rigid, and only bend where your toes bend.  Footwear with a larger toe box region may help alleviate symptoms and prevent progression of the hammertoe.
  • Splints – Toe props and silicon devices can be used to help alleviate the pressure on the toes.  These can be used to reduce any rubbing which may cause irritation.
  • Custom orthotics – Orthotics can help to redistribute pressure evenly across your feet and allow your toes and forefoot to work more efficiently.
  • Surgical correction – In some cases, surgery may be required to correct the hammer toe by fusing the joint or shortening the tendon.

If you are suffering from hammertoe, or any pain or discomfort in your feet or lower limbs, give us a call at Watsonia Podiatry on (03) 9432 2689 or click here to book an appointment today!


Aaron Dri