Toe Issues: Hammer, Claw, and Mallet

Posted by on Tuesday, September 18th, 2012

Hammers, mallets, and claws all have their place in the world–for example, at a construction site, in a kitchen, or on a cat. They shouldn’t be on your toes, but alas, sometimes they show up there.

We’ve talked about hammertoes before, so today let’s examine how those stack up (or curl up ) against two similar conditions: claw toes and mallet toes.

What are hammertoes, mallet toes, and claw toes and what do they have in common, other than tough-guy names and the word “toes?” These are all conditions where your toe is constantly forced into an unnatural position until it eventually stays that way. Here’s the breakdown:

  • Hammertoes A hammertoe is a toe that bends downward at the middle joint. It usually occurs in the second toe, and often is found in people who have bunions.
  • Claw Toes A claw toe is bent at two points: the first joint at the base of your toe where it meets the top of your foot and the middle joint. Claw toes typically form in all four of a person’s little toes (which gives their foot a more, well, claw-like appearance).
  • Mallet Toes A mallet toe is a toe that bends at the top toe joint, which is located near the tip of your toe. Mallet toes are most common in the second toe, but can also occur in the other toes as well.

What makes toes bend into these kind of crazy shapes? The most common cause is shoes where the toe box is too tight and shaped in a way that does not allow the toes to lie flat naturally. Yes, we are talking about you, pointy-toed stilettos.

When your toes are squashed into these kinds of shoes, the muscles that help you bend and straighten your toes tighten up into a bent position. If this keeps happening on a regular basis, it becomes harder and harder to straighten your toes again, even when they’re not in tight shoes. Eventually they stay that way.

Tight shoes aren’t the only cause of hammer/claw/mallet toes, though. Some people are born with them. Others have them develop as the result of an accident, either trauma directly to the toe, like a fracture, or a spinal cord injury that affects the nerves that control the muscles. Diseases where a person has little feeling in their toes, such as peripheral artery disease or diabetes, can also cause toes to curl or bend.

If I don’t care that my toes look a little weird, should I worry about hammer, claw, or mallet toes? Yes. For one thing, they can affect your balance and the way you walk, and that can lead to other problems with your feet. You can also develop corns at the peak of the toe bend where it rubs against the top of a shoe. Corns are painful and need to be managed so they don’t get scraped into open sores. It’s one thing to have toes that are bent in a weird way; it’s another level of nastiness to have bent toes with red, rough sores on them.

Okay, so what can I do about these problem toes? The good news is that you can stop the curling before it gets too bad. If a toe is hurting and looks like it’s starting to curl, take action right away by making sure that you wear shoes that allow all your toes to lie flat. In time your problem toe may relax again, or at least it won’t get any worse. Of course you can stop the problem before it starts by wearing shoes that don’t squish your toes most of the time; save your high-heeled, pointy-toed shoes for special occasions. If  you work in a business where these uncomfortable, destructive shoes are considered part of the dress code, kick them off as often as you can, like when you’re at your desk (provided your cubicle mate doesn’t mind the foot oversharing).

If you already have hammertoes, claw toes, or mallet toes, you can try to make them better by seeing a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) to talk about orthotics that can help support and give your toe relief, as well as exercises that may help strengthen and straighten them. If you have corns, you can buy small pads in any drug store to put over your corns and protect them from additional shoe friction. If none of these remedies help, there are surgeries for these types of toe problems, but they can be difficult, and won’t prevent toes from curling back up if you then go back to wearing the same type of shoes that caused the bending in the first place.

There’s no winner in the hammer vs. claw vs. mallet toe game. All are unhappy things that you don’t want to have happen to your feet. So pay attention to your toes and give them the room they need in your shoes.

 

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.