Understanding How Hammer Toes Form

What is a hammer toe?

A hammer toe is an abnormal, continuously bent toe (flexed). It can be one or both joints of the second, third, fourth, or fifth toes. When the joints (knuckles) in the affected toe bend, this moves the toe joints upward. That is because the tip of the toe is forced downward, and often curls under, closer to the ball of the foot. This makes the first toe "knuckle" higher than the neighboring, unaffected toes. This also produces painful and irritating contact with the shoe.

PRESSURE SORES STAGES

Hammer toes get worse with time, contracting more and becoming increasingly rigid. This causes increased pain and disability. In the earlier stages, hammer toes (like bunions) are still flexible. Normally, they don't arrive over night. It is a slowly evolving condition. The longer hammer toes (and bunions) exist without an effective foot and toe stretch exercise program, the more rigid they become, just as any joint in our body. Toes living their lives in shoes get the least amount of proper exercise of any joint system in the body.

To make matters worse, we hide our feet for protection and for fashion inside tight shoes. To compound matters further, our feet are located at the outer reaches, the most distant orbits on our heavenly body. Out of sight, out of mind. However, the most significant obstacle our feet face is a black hole of understanding that keeps us poorly informed and in the dark.

Only recently has the hammer toe and bunion business been liberated from the lockstep monopoly of "Wait and see if it gets worse" (and of course it will) and "we can schedule surgery if it doesn't improve". The product of the "wait" approach has been to live with the pain, embarrassment and disability until it progresses to a severe stage. Then an invasive procedure almost sounds commonsensical.

An informative way to understand hammer toes is to view them as a vertical bunions (up & down vs. sideways). Both are caused by improper and constant pressure without counterbalancing stretch and exercise program. The pressure results in permanent muscle imbalances in the toe. If muscle balance in your toes is disrupted, your ability to skillfully and safely balance your body is disrupted. Instead of pushing the toe sideways toward the center of the foot as with a bunion, hammer toe pressure is pushing the toe backwards, toward the ball of the foot. The toe has no choice but to bend up and that is the beginning of a hammer toe. No room in the end of your shoes for five toes to fit, so one or more volunteer to bend, shorten and lift up. Voila, hammer toe!

Understanding How Hammer Toes Form

PRESSURE SORES STAGES

Hammer Toes X-Rays Can Be Revealing

Hammer toes x-rays are sometimes ordered when a patient has pain on the bottom or in the ball of the foot, especially if the deformity is not obvious. Redness on the top of the affected joint is often the first sign. If the redness is noticeable, your doctor might not order an X-ray.

Physical examination is sometimes the only necessary diagnostic tool. After evaluating the location of a person's pain, if pain is present, and physically manipulating the joints, it is often possible to see the stiffness that is symptomatic.

PRESSURE SORES STAGES

During the early stages, before obvious deformity occurs, it is possible to correct the problem by improving flexibility. Exercises geared towards stretching the tendons and increasing muscle strength may help. But, it all depends on the severity or advancement of the deformity.

Accompanying problems are another factor that helps to determine treatment. A condition called "cross-over-toe" can accompany a hammertoe and a bunion on the big toe. The root cause of this problem is the bunion.

During hammer toes x-rays, the bunion would be seen in views taken from the top of the foot. They occur in the first joint (closest to the foot) of the big toe. In the X-ray, the joint will appear enlarged and the toe will point towards the others, to varying degrees.

If the bunion is not corrected, there will be continued pressure on the second toe, which may cause pain, blistering, corns or calluses. Eventually, the second toe develops the hammer-appearance and in order to accommodate the deformity in the big toe, the second toe becomes an overlapping or cross-over-toe.

Like many other problems affecting the health of the feet, hammertoes and bunions are often caused by poorly fitting shoes. Narrow, pointy-toed shoes are common causes, but over-pronation may be involved, too.

Hammer toes x-rays may not reveal over-pronation. Taking an imprint of the bottom of the foot is the usual method of diagnosis. A low or absent arch will be present, which can be observed on the imprint.

In over-pronation, the heel angles inward. So, instead of balanced pressure throughout the foot, more pressure is placed on the inside area, the side with the arch.

Examining the person's posture and appearance of their knees is another diagnostic method. In severely pronated feet, the person appears knock-kneed.

If your doctor orders hammer toes x-rays, he or she may also do these other diagnostic tests to find related problems and come up with an effective treatment plan. If over-pronation is a problem, orthopedic insoles may be used to straighten to provide support and reduce the pressure on the knees and other lower-body joints.

These are not problems that should be overlooked or taken lightly. The health of your feet affects the health of your total body. Deformities can become permanent. The irritation and inflammation caused by the initial problem can contribute to arthritis in other joints of the body.

So, if your doctor orders hammer toes x-rays, take his advice. Before you even visit your podiatrist, consider buying more practical shoes. That's the first step.

Hammer Toes X-Rays Can Be Revealing

PRESSURE SORES STAGES