Hammertoe: Hammer toe is a deformity in which there is downward bending of the middle joint of the toe or the proximal interphalangeal joint (PIP). Although it can affect the other toes, it most commonly affects the second toe. It may be present at birth or may result from wearing shoes that are too tight which forces the toe to bend forward. It causes no pain and does not require any specific treatment. Hammer toe can be treated by ensuring that your child wears well fitting shoes that has enough space for the toes to stretch.
Cause of Hammer Toes
Hammer toe or clawed toes can be made worse by tight fitting footwear or socks, particularly during childhood when growth and development may be restricted. In particular the second toe is susceptible to referred pressure / trauma when a bunion or hallux limitus is present.
Signs and Symtoms of Hammer Toes
A bunion is the name given to swollen, bony bump on the outer side of the big toe joint. A bunion forms when the bones of the joint at the base of the big toe pushing it towards the second toe. This forces the joint outwards and the resulting pressure between the bone and the footwear causes the tissue to become inflamed and sore. Tight fitting footwear can make the condition even more painful. The condition can also lead to corns, blisters and hammer toe. Bunions can be caused by the way you walk and there’s a strong hereditary link to their occurrence.
Prevention of Hammer Toes
Wearing shoes that fit properly can help bunions from getting worse, while cushioning products can ease the pain. If you suspect a bunion forming, consult your podiatrist for advice.
The bunion takes its name from the Latin word for turnip (bunio), thereby suggesting a rounded, hard-skinned, and sometimes purple-coloured swelling. That is more or less how a bunion appears – an inflamed swelling of the main big-toe joint where it meets the mid-foot.
Less frequently bunionettes or ‘tailor’s bunions’ can also occur on the joint of the little toe.
Causes
Bunions are one of the most common foot problems. They often run in families, which suggest that the inherited shape of the foot may predispose people to them. However the bunion itself is not what is inherited, but the poor or faulty foot type. That mechanically can lead to the instability in the joint that will eventually lead to a bunion.
The wearing of footwear that is too tight, causing the toes to be squeezed together, with inadequate arch support or the regular use of high heels is the most commonly blamed factor for the cause of bunions and HAV. This could be the reason for the higher prevalence of bunions amongst women.
An incorrect walking action or one which is impaired by other factors like ‘flat or pronated feet’, results in an abnormal motion and pressure over the joint. This over many years combined with ill-fitting footwear also leads to instability in the joint and subsequent bunion and HAV.
Some activities e.g. Ballet, puts additional pressure on the joint and may increase the chance of bunions developing.
Treatment
Bunions are almost always progressive and tend to get larger and more painful with time.
The initial goal of any treatment is to alleviate the pressure on the bunion and to stop the progression of the deformity with the use of suitable padding. It is also possible to mould a material between the big toe and the second to slow or stop the progression. Physical therapy can be used to improve the range of motion.
If the symptoms of the bunions do not respond to the conservative measures or if the bunion has progressed past a threshold where these measures are not effective, bunion surgery may be necessary.