Simple steps can reverse hammertoe

DEAR DOCTOR K: Can hammertoe be reversed?

DEAR READER: The four smaller toes of your feet are composed of three small bones, connected by two joints. Hammertoe develops when tendons and ligaments – the fibrous tissues that connect muscles and bones to one another – contract. Instead of lying flat, the toes very slowly start to hump up. A bend develops in the joint between the first and second bones; the tip of the toe starts to curl up. The toe resembles a hammer, hence the name.

Fortunately, hammertoe can be reversed. Some simple treatments include:

• Splinting the toe to keep it straight and to stretch the tendons of the foot.

• Using over-the-counter pads, cushions or straps to decrease discomfort.

• Exercising the toes to relax the tendons (a physical therapist can recommend appropriate exercises).

• Wearing shoes that fit properly and allow toes plenty of room to stretch out, and generally avoiding ill-fitting, tight or high-heeled shoes.

If the toe has become stiff and permanently bent, the toe can be straightened with surgery. One type of surgery involves removing a small section of the toe bone to allow the toe to lie flat.

Most cases of hammertoe can be prevented by wearing the correct shoes. If you go back to tight, pointy shoes, the condition can return even after it has been treated.

If you notice the beginning signs of hammertoe, you may be able to prevent the tendons from tightening. Regularly flatten your toes. Also, soak your feet in warm water every day, then point your toes.

Simple foot exercises also can help to maintain or restore the flexibility of the tendons. For example, place a small towel on the floor and then pick it up using only your toes. Or grasp at carpet with your toes, or curl your toes up and down repeatedly.

Fortunately, hammertoes take a long time to develop. If you notice them starting, you can often prevent them from worsening by following the advice I’ve given.