DEAR DOCTOR K:
I am a 57-year-old woman with hammertoes, which can make walking or standing painful. The worst part is that I like to walk for exercise, so this problem is cutting into my health regimen. What’s the best way to deal with this problem?
Ah, the toes. They’re a small part of our bodies, but crucial to keeping our balance and walking or running well. And as you now know, woes with your toes—and hammertoes are among the most common—can take away the simple pleasure of walking.
Hammertoes are toes that get “stuck” in a bent position because the tendons and ligaments in the toes have been pulled tight. They’re called hammertoes because they look like the little pieces inside a piano called hammers.
In many cases, the culprit is fashion. If you are fond of high heels (particularly ones with pointed toes), and wear them a lot, that could have contributed to your problem. We know that supportive, flat-soled shoes are better for your feet (and can be quite fashionable these days).
Constantly squeezing toes into narrow shoes forces them into an unnatural position. Women are four times as likely as men to develop hammertoes. The shoes women often wear are the main reason that women more often have woes with their toes than men do.
But today’s shoe trends don’t get us off the hook completely when it comes to hammertoe risk. The flip-flops I see all over campus in the summer can cause hammertoes, too. Why? Because in order to keep them on, wearers often grip with their toes as they walk—and all the extra gripping trains the toes to assume that position.
How do hammertoes make your feet hurt? They can shift the position of the fat pads that normally protect the balls of your feet. Adding insoles to your shoes could make a big difference. Many patients tell me they like the ones made out of neoprene, the same synthetic rubber used to make wet suits.
If your hammertoes are still flexible, you can buy little “crest” pads that push the toes down when you’re wearing shoes. There are also splints and pads designed to straighten crooked toes. Hot soaks can help with joint flexibility, and applying ice may help reduce swelling and inflammation.
Once a hammertoe stiffens, no amount of retraining is going to help. The goal then shifts to accommodating the toe with roomy shoes and preventing friction. You can have your hammertoes made straighter with surgery. Most of my patients, however, get enough relief with other treatments that they don’t need to consider surgery.
Hammertoes, bunions, fallen arches and other miseries of the feet are not on any doctor’s list of major medical problems. Yet one of the healthiest things that we human beings can do for ourselves is walk—regularly and briskly, for at least 30 minutes, at least five times a week. When “minor” miseries of the feet rob us of the health and pleasure of walking, I’d call that a major problem.