Hammer Toe


Experience From - John Vonhof , Pat Wellington , David Dinkel , Zoie Ensslen ,

John Vonhof (Author: FIXING YOUR FEET : Preventive Maintenance and Treatments for Foot Problems of Runners, Hikers, and Adventure Racers)

"I've been diagnosed as having a hammer toe that has caused me much pain during this past ultra season. My podiatrist has suggested surgery which will lay me up for 2-3 months, not too thrilled by the prospect of that. Only other option appears to be to continue putting up with the pain as more conservative treatments apparently rarely work for this problem."
I have not had surgery for hammertoes but am an orthopedic technician and work in an ER and have seen many degrees of hammertoes over the years. In my mind the question is, "Which is the better option--in the long run?"

Surgery may lay you up for a while, but will offer the best retrun for your pain and money. Alternatives like modifying shoes and shoe inserts only offer short term results, and in the long run will add up to as much as the surgery likely costs.

Have you gotten a second opinion? I would. If you have seen a podiatrist, then find an orthopedic surgeon for a second opinion. Look at the following web sites:

Americian Academy of Podiatric Sports Medicine

American Academy of Orthopaedic Surgeons

American Orthopaedic Foot and Ankle Society

These can offer referrals and good reading. Good luck.

Pat Wellington

Al Czecholinski asks about surgery for hammer toes:

Al, I would suggest that before you opt for surgery, make sure your shoes have a VERY DEEP TOE BOX.

I have never had problems with my left foot, but my right food is a disaster, with hammer toe, heel spur, and much higher arch than my left foot. If it weren't for Dr. Rich Blake at St. Francis Sports Medicine Center in San Francisco creating my magic orthotics for crippling heel spur pain back in 1984, I wouldn't be running today.

I never had a problem with the hammer toe until 1989 when all of a sudden I had excruciating/crippling pain on the ball of my foot under the hammer toe, which made running impossible. At that time, Dr. Blake said hammer toe surgery is very common, but surgery is still a last resort. He suggested stretching the toe and doing exercises like picking up a towel with my toes--But since my tolerance for stationary exercises is nil, that was not the answer.

Dr. Blake had actually "corrected" my first orthotics made by another quack podiatrist that weren't correcting for heel spurs--but that's another story. Anyway orthotic materials improved dramatically in five years and the "corrected orthotics" needed to be replaced. I was also due for new shoes.

With the new shoes and new orthotics, the hammer toe pain disappeared. While I believe the new orthotics played a part in redirecting the foot pressure, the most important difference was the much DEEPER TOE BOX of my new shoes. Since 1989, I've always made sure my shoes have a very DEEP TOE BOX, and have never had the pain on the ball of my foot under the hammer toe again. I also keep a corn pad on top of the hammer toe, as well as the toe beside the hammer toe so nothing rubs.

David Dinkel

I had hammer toe surgery done on one toe on each foot in 1988 after running for about 7 years. I had been running marathons every year and sometimes running would be excruciating pain and when the toe would snap I would feel a pain like a needle that would go from my toe through my ankle and all the way up my leg to the spine.

In 1988 I went to run the Pike's Peak marathon and the guest speaker the night before was a Podiatrist with the Olympic training team. I talked about my condition with him and the fact that I was a diabetic and 33 years old. Because he knew how important the running was to me to control my diabetes he told me to definitely get the surgery. I then went to a podiatrist in Wichita Kansas and I can't believe the results I got from the surgery. He removed one of the bones in each of the hammer toes without cutting any of the tendons so that I would still be able to have motion control of the toes.

The results are just next to miraculous. Within about 5 weeks I was able to start jogging again and within a few weeks after that I was back on a full running program. I have had no pain since then and have recommended the surgery to anyone else who is suffering from the same condition that I had. I have been running continuously since then and have been doing ultras for about 7 years now. I finished my first 100M at Kettle Moraine this year.

I strongly recommend the surgery but be sure that you are going to a board certified podiatrist because this is a very delicate surgery and if done wrong it could ruin your running forever.

Zoie Ensslen

I agree with Tim completely, exhaust all means of conservative treatment. I would go a step further and go to the Physiotherapist first, there again you need to be sure you are seeing a reputable sports therapist. But a good one can give you a much more realistic outlook on the problem and the prognosis. I agree with David also - if you are looking at surgery then be very careful about the surgeon. I have heard the same thing that David said - it can be a miracle or it can be a disaster.

I have two hammertoes (second toe both feet) as well. So far, exercises the Physiotherapist has given me and some protective padding has helped. My therapist tells me that my good luck can continue for some time. Recently I wrote everyone about a Plantar Fasciitis problem I was having and received some wonderful advice. I have also since found out that that was the result of a different problem. My metatarsal's on both feet had fallen causing not only that pain, but also the Plantar problem. A combination of the good advice I received from everyone - more new exercises to strengthen the muscles in my feet and a metatarsal brace for both feet are bringing me back to recovery.

And a word to support something that RichRuns said: most sports doctors and physiotherapists will tell you that you can run much sooner than would be expected if they understand that pain is your friend. The main question that should be asked is: will it harm recovery or make any problems worse and is there any limit that should be placed on my running or type of workout. You'll be surprised at how often they say - go for it! or how soon you can begin after surgery.