Have you examined your feet lately? Specifically your toes? If you notice a toe that is bent or pointing at an odd angle, you may suffer from a hammer toe.\n\u201cHammer toes are deformities in one of the four little toes of the foot,\u201d explains orthopaedic surgeon Carl Hasselman, MD, of the UPMC Foot and Ankle Center. \u201cWhereas normal toes look straight, hammer toes become flexed or curled. As they bend, they stick up at the middle knuckle of the toe, making the affected toe look like a hammer.\u201d\nHammer Toe Causes and Risk Factors\nThere are several causes of hammertoes, according to Dr. Hasselman, but mainly it has to do with what you wear on your feet.\n\u201cFor women especially, ill-fitting shoes can cause an issue,\u201d he says. \u201cYour toes are being scrunched in the shoe. There\u2019s not enough adequate space for them to move.\u201d\nOther common causes of hammer toe include:\n\nDiabetes\nNeuropathy\nProblems with the tendons in your toes\n\n\u201cAge, sex, and toe length can make certain individuals more susceptible of developing hammer toes,\u201d says Dr. Hasselman.\nHammer Toe Symptoms\nBesides their physical appearance, hammer toes are most often characterized by pain.\n\u201cAs that knuckle rubs inside against the shoe, it\u2019s going to hurt,\u201d explains Dr. Hasselman. \u201cEventually, you will develop thicker skin in that area, which is what we call a corn or a callus. These are also painful.\n\u201cIf left untreated over a long period, this rubbing can create a hole in your toe, which may lead to infection.\u201d\nHammer Toe Diagnosis and Treatment\nHammer toes can be diagnosed visually during a physical exam. An x-ray may be ordered to rule out other possible or less common causes of the problem.\nOnce the diagnosis is made, Dr. Hasselman says the majority of hammer toes can be treated non-operatively. He starts treatment by counseling patients on appropriate shoe wear.\n\u201cI have my patients stand on a piece of paper and I\u2019ll draw the outline of their foot without a shoe on,\u201d he explains. \u201cThen I\u2019ll take their shoe and lay it over the area I just drew. It\u2019s amazing how many times the toes aren\u2019t actually covered by the shoes. This tells me you\u2019re scrunching your toes.\u201d\nHow to prevent hammer toe\nTo prevent hammer toes, Dr. Hasselman urges his patients to wear shoes with adequate room for the toes. For those who already have hammer toes, patients may be encouraged to use braces, orthotics, padding, or sleeves.\nHammer toe treatment without surgery\n\u201cOnce you have developed a hammer toe, tennis shoes, or shoes with very soft leather are good to wear,\u201d he says. \u201cAvoid anything with a hard material on the top because they will not bend or give with the deformity.\u201d\nIf nonsurgical treatment is unsuccessful, there are surgical options available.\nHammer toe correction surgery\n\u201cThe surgery is designed to straighten the toe, so it lies flat when you are standing or walking,\u201d Dr. Hasselman explains. \u201cSometimes I need to lengthen the ligament or tendon. Other times I need to remove part of the bone.\n\u201cThese surgeries are done on an outpatient basis through small incisions. Most of the time, patients can walk with a post-operative shoe immediately. It\u2019s definitely considered minor surgery if it needs to be done.\u201d\nWhether you have a new injury, or symptoms that include chronic foot pain, ankle pain, heel pain, swelling, or limited movement, our skilled foot and ankle surgeons offer comprehensive treatment options to help you find relief. To learn more, visit the UPMC Foot and Ankle Center online or call 844-ANKFOOT to make an appointment to speak with an expert.