What is Hammer Toe?
Hammertoe is a condition where there is excessive pressure on the toes, causing them to curl upward. This results in pain and discomfort when walking.
Hammertoes are painful foot deformities that cause pain when walking or standing. They’re often associated with diabetes, arthritis, and obesity.
What Causes Hammer Toe?
So there’s an entity and foot health that involves an imbalance of the the muscles and tendons going to the toe and the most common type of that is known as a hammer toe. What ends up happening with a hammer toe, is the first joint in the toe begins to get lifted in the upward direction, and the most likely reason for that lifting in the upper direction is to things that are present in almost all shoes.
Shoe Design
The first thing that’s present in shoes, since about birth, or at least since 1 or 2 years is we put an elevated heel on to shoes and what I want you to notice across this joint level is when the heel gets elevated with shoes.
These top of the foot tissues are going to shrink and contract and get shorter. That’s one of the things that the body does whatever position it gets held in, it will learn so early on in life. We begin the process of hammer toe by elevating our heels.
More commonly the shoes feature known as toes spring, which lifts our toes coupled with the heel elevation, is responsible for a tightening and a shortening of not only the structures here, but the long extensor tendons that go to the very last toe bone.
So as we begin this process of creating the hammer toe and and the tissues become tight, the first thing we see is the toe bones sitting up a little bit. Extensor muscles are antagonized by muscles on the back of the leg and bottom of the foot known as flexor muscles.
So as soon as the extensor muscles on the top of the foot start to get short and contracted the muscles on the bottom of the foot, flexor muscles will try to re-establish that balance.
The Extensor Tendon & Flexor Tendon
Unfortunately, what they’ll do is they’ll begin buckling the first knuckle in the toe – this is known as hammer toe and essentially the hammer toe would look like this, and so the extensor tendon gets tight and then after the extensor tendon gets tight.
The flexor tendon begins to try to pull the toe down, and the downside of this is if this this toe configuration is left for too long. It will stay like that. It will become what’s called a rigid mirto, where the individual, nor the physician will be able to re-approach summate a straight toe position.
So conventional traditional therapy is to place your faith in one of three biomechanical theories out there about the extensor muscles trying to substitute for tight calf muscles or the flexor muscles trying to stabilize a inflexible arch.
The Reality About Hammer Toes
Those are unproven theories and are so much harder to believe in what is clearly evident and able to be seen in shoes, so, unfortunately, conventional podiatric care typically tends to ignore the fact that most shoes have an elevated heel and most shoes have a toast spring.
Instead, believing that maybe the inclusion of an orthotic device somehow can reestablish biomechanical balance, unfortunately, too often people are given an operation for a hammer toe which consists of incision incision across the top of the foot, releasing the ligaments on the other side of the joint, literally Removing the joint and fusing those bones together, oftentimes the extensor tendon – gets lengthened with a surgery, as opposed to the way that we lengthen it, which is with stretching so natural preventive.
Conservative care for hammer toes, is to understand a foot where’s the cause.
How to Rehabilitate Hammer Toe
So we want to avoid the elevated heel, we want to avoid the toast spring and we especially want to avoid the shoe getting narrower from the ball and pinching.
In once, we have established the proper natural position. We begin the process of rehabbing the hammer toe and we start that process by gaining greater flexibility across the top of the joint. And we do that by doing the tote extensor stretch, which is the stretch here – and this stretch, takes these extensor tendons which come from these muscles here and it begins to establish greater flexibility.
So that’s step one step two.
Hammertoe Prevention and Treatment
Once the extensor tendons get more flexible, we ask the individual to pull up on the very end of the toe, which also will re-establish the length in the flexor tendon, and so essentially, what we’re doing is we’re we’re, making the toe go straight, extensor stretch or stretch.
If a person can address their hammertoe before it becomes a rigid, fixed hammer toe, these natural preventive strategies can be very helpful.
We also very much want to use a metatarsal pad to help pull the toe back out of that extension deformity and oftentimes also we’ll use a silicone toe separator, because the toe separator will actually begin pulling down the first component of the hammer toe, which is the proximal phalanx, which is in extension, so the correct toes will begin pulling that down the weight-bearing force of the ground and the metatarsal pad will begin lifting up on the end of the toe and that’s how we reappropriation.
