Hammertoe and mallet toe are two types of toe joint deformities that can affect adults. Hammertoe involves the toe bending down at the middle joint, and is most common on the second toe. Mallet toe is when the toe bends at the joint nearest the end of the toe; it also typically happens to the second toe, but can occur on any toe.
These toe deformities happen when the toe muscles stay bent for too long, over time, such as by consistently wearing tight shoes. The ligaments and tendons around the muscles are no longer able to hold the toe straight, and the toe bends. Women are more likely to get hammertoe or mallet toe due to shoes with heels that put pressure on the toes or that have narrow toe boxes and press the toes together.
Other types of foot conditions can lead to toe joint deformities. These may include arthritis and diabetes, which can impact circulation to the toes. A trauma to the foot can also cause toe deformities.
You may be at slightly greater risk of getting hammertoe or mallet toe in your second toe if it is longer than your big toe.
Besides seeing your toes out of alignment, you’ll typically feel pain in your toes and feet if you have hammertoe or mallet toe. Movement may be difficult, which may impact your daily activities.
The misaligned toes may then cause the other toes to push out, which can lead to blisters, calluses and corns wherever your feet rub against your shoes.
Several causes and risk factors for hammertoe and mallet toe have been identified.
The older you are, the greater your risk of developing hammertoe or mallet toe and females are more likely to develop the conditions than males. Flat-footed people are more likely to develop hammertoe or mallet toe, as are those who have a particularly high arch of the foot.
Hammertoe and mallet toe are also more common in people with arthritis and diabetes than the general population. If you have diabetes and also a corn or ulceration on a toe, you are at particularly high risk because this means there is a large amount of pressure being placed on that toe.
Wearing shoes that are tight in the toe area can cause hammertoe and mallet toe by keeping the toes in a cramped or curled position over long periods of time. This may eventually become permanent.
An injury to a toe can increase the risk of that particular toe developing into hammertoe or mallet toe.
The first step to mitigating the pain of toe joint deformities is to wear supportive and comfortable shoes. Your shoes should have plenty of room in the toe box and not have a high heel.
Your doctor can also fit you for orthotics, which are inserts that can re-position your toes so they can eventually straighten. You may also be advised to tape your toe, which will put it into the proper position, or use toe caps or other support.
In some cases, physical therapy and home exercises that stretch the affected muscles can help straighten the toes. In other situations, surgery on the tendon of your toe may be necessary.
Avoid wearing toes that are cramped in the toe box. Many brands of shoe are available with a wider area for the toes, allowing them to spread out. Using silicone or other padding above the toes can also be a useful preventive measure, as can using an arch support. Avoiding trauma to the toes will also reduce your risk.
If you do develop a corn on any toe, you can use a pumice stone to reduce its size. You should do this after a warm bath or after soaking the feet in warm water.
Toe exercises may also be beneficial, such as repeatedly stretching the toes out and curling them up. This may help prevent the toes becoming locked in the contracted positions associated with hammertoe and mallet toe.