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.

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!