Definition: Normal toes extend straight out, but when hammer/claw toes develop they will have an abnormal bend at the middle joint of the toe. This generally occurs in the 2nd, 3rd and 4th toes with the 2nd toe being the most common.

Function: The main function of the toes is to enlarge the contact surface area of the forefoot for walking. In general toes assist in balance, gripping and propulsion.

Mechanism of Injury

When the extending and flexing muscles of each toe do not work together, there becomes an imbalance in the pressures at the joints of the toe. This in turn creates a tendancy of the toe to flex or claw.

Signs & Symptoms

  • Your toes no longer extend straight out but rather look like upside down 'U's or 'V's
  • Hard skin known as corns may develop on the top joints of your toes from rubbing on the inside of footwear that may now be too shallow.
  • Pain can also develop under the ball of the foot of the bent toe.
  • Toe joints may become an angry red colour.

Causes

  • Bunions/Hallux Valgus in where the big toe drifts towards the 2nd and lesser toes, which crowds the lesser toes and changes the mechanics
  • Improper fitting footwear is one of the biggest reasons for hammer/claw toes.

Pedorthic Treatments

Custom made Orthotics can be an effective method to reduce your toe discomfort. They are able to redistribute and load the foot in a different way in order to decrease stress to the toes. Pedorthists use interventions such as supporting your medial/inside arch, and using metatarsal domes and bars to support the metatarsal arch. Proper footwear is also pivotal to your recovery. Shoes with a wide and deep toebox along with no stitching across the toes will decrease pressure on the toes. Toe crests, toe spacers and silicone sleeves can help reduce the friction in some areas. Talk to your Pedorthist about proper footwear choices for you.

Other Treatment

  • Physiotherapy
  • Surgical correction
  • Splinting devices may hold toes down in your shoes

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