What are hammertoes?

OK... I admit it. I see a lot of hammertoes. And I am always asked, "Why are my toes crooked?" Basically you have either a foot with an arch to high or a foot with little to no arch.
Our bodies are three dimensional so hammertoe deformities can happen in all 'three dimensional planes'. The one podiatrists see most frequently is in the 'sagittal' plane of deformity which means the toe is bent in up and down. The second most frequent deformity is in the 'transverse' plane of deformity where the toes move from side-to-side or what most people refer to as an "overlapping" toe. The final plane of deformity is what we refer to as the 'coronal or frontal' plane were the toe wants to 'roll'. We see this mainly on the great toe or the little toe and is generally associated with a bunion. (More on bunions in another post).
Hammertoes occur at the joint closest to the foot. If any of these deformities occur at the joint closest to the tip of the toe, it is referred to as a 'mallet' toe.
If you are interested, here is the physiology of what causes hammertoes:
1: Flat feet - pes planus: (Flexor stabilization) A flat foot is a flexible or hypermobile foot. We in podiatry refer to this as 'excessive pronation'. The middle of the foot fails to lock while walking creating a very mobile front of the foot. The 'flexor' tendons work to early in an attempt to stabilize the foot causing the toes to bend.
2: High arched feet - pes cavus: (Flexor substitution) muscles in the back and side of the calf are weak causing an inability to plantarflex the foot (basically to move the foot down). The muscles located in the foot contract creating a high arched foot and thusly, hammertoes.
I am asked if hammertoes can be prevented. The answer is yes and no. Good custom molded orthotics can help keep the feet in correct alignment thus either helping to prevent or at least slow down the deformity. However, by the time I see people in my office, the deformity has reached a point to where the only correction is to perform reconstructive surgery.

"The journey of life is taken one step at a time... none of them should be painful." G.M. Barclay, DPM, AACFAS