What is hammer, claw or mallet toe?

A hammer toe is a toe that bends up at the middle joint, while the end of the toe points down. The problem usually happens to the second toe.

A hammer toe can hurt a lot, especially as the toe rubs against the shoe when your child walks. Shoes that are too tight can cause hammer toes. If a shoe forces a toe to stay bent for a long time, the muscles in the toe get tight and the tendons that connect the muscles to the bone get shorter. Over time, the muscles cannot straighten the toe. Sometimes, diseases such as rheumatoid arthritis also can cause hammer toes.

Early treatment can help your child's toe straighten before it gets badly bent. Your child can wear roomy shoes and use pads to keep the toe from rubbing against their shoe. If the toe is badly bent, your child may need surgery to straighten it.

Hammer, claw, and mallet toes may hurt and make it hard to find shoes that fit. They may rub against your footwear and cause calluses or corns. In more severe cases, these toe problems may affect your balance and make it hard to walk.

You may need surgery if your toe is painful or limits activity and other treatments don't work. The type of surgery depends on whether the toe joint is fixed or flexible. In general, surgery is used only for severe toe problems. And it may not be right for everyone.

Your doctor will ask questions about your symptoms and past health and do a physical exam. Questions may include when the problems started, what makes them worse, and what kind of shoes you wear. The doctor will check whether the toe joint is fixed or flexible to decide if surgery is needed.

• Have your child wear shoes that have lots of room in the toes.
• Follow your doctor's directions for putting a splint on your child's toe, if your child is given one.
• Gently stretch your child's toe with your fingers.
• Use toe pads or corn cushions to keep your child's toe from rubbing against their shoe. This may keep a corn from forming on the top of the toe.
• Have your child wear a shoe insert, or orthotic, to cushion the bottom of the bent toe.

Tight shoes are the most common cause of these toe problems. Wearing tight shoes can cause the toe muscles to get out of balance. If a shoe forces a toe to stay in a bent position for too long, the muscles tighten and the tendons shorten, or contract. This makes it harder to straighten the toe. Over time, the toe muscles can't straighten the toe, even when you aren't wearing shoes.

These toe problems form over years and are common in adults. Women are affected more often than men because they are more likely to wear shoes with narrow toes or high heels.

Less often, these toe problems are linked with other conditions, such as diabetes, rheumatoid arthritis, stroke, or an injury to the foot or ankle.

Hammer, claw, and mallet toes are toes that are bent into an odd position. They may look strange or may hurt, or both. These toe problems almost always happen in the four smaller toes, not the big toe.

• A hammer toe bends down toward the floor at the middle toe joint. This causes the middle toe joint to rise up. It usually affects the second toe. Hammer toes often occur with bunions.
• Claw toe often affects the four smaller toes at the same time. The toes bend up at the joint where the toes and the foot meet. They bend down at the middle joints and at the joints nearest the tip of the toes. This causes the toes to curl down toward the floor.
• A mallet toe bends down at the joint closest to the tip of the toe. It often affects the second toe, but it may happen in the other toes too.

If you notice that your toe looks odd or hurts, talk to your doctor. You may be able to fix your toe with home treatment. If you don't treat the problem right away, you are more likely to need surgery.