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Harvard Medical School
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General Medical Questions
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Question : Over the past few months I have noticed that my toes feel "tight," almost "crunched" together. They look fine, but I fear this may be the beginning of hammertoes. Is there anything I can do to prevent this?
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The Trusted Source
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Howard LeWine, M.D.

Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.

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August 02, 2012
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A:

Yes, there are some simple things you can do to prevent hammertoe. This is a condition in which the toes bend in the middle and take on the look of a hammer. It is thought to happen as a result of shortening of the tendons that pull the toes upward (away from the ground). This is possibly because of years of “abuse” in tight shoes, arthritis, or bunions.

Some cases of hammertoe seem to be inherited. Over time, the shortening of the tendons may become permanent so that the affected toes cannot be straightened. At that point, only surgery can offer a solution.

The good news is that hammertoe can be prevented in most cases by wearing shoes that give the toes plenty of room. That means:

  • Avoiding shoes with narrow toes
  • Avoiding high heels that force the toes forward into the crowded front part of the shoe
  • Buying shoes that leave a half inch of space in front of your longest toe

A feeling of crowding or tightness in the toes may be the earliest symptom of hammertoe. But if your toes appear normal to you and do not hurt (especially when you are barefoot), its likely that hammertoe has not yet developed and arthritis is not the cause. It may be possible to prevent hammertoe by changing your footwear now, which allows your toes to flatten regularly. You can also do some simple stretching exercises. For example, pick up a towel from the floor repeatedly, using only the grip of your toes.

It is also possible that your symptoms are due to something else. So if the crowding sensation does not get better with a change in footwear and stretching exercises, see your doctor.

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