As summer approaches and more people opt for sandals or flip flops, foot issues like hammertoes and corns become a concern for many. Dr. Prianka Sharma, a podiatrist at St. Joseph’s/Candler, frequently treats these conditions and offers insight into their causes, treatments, and prevention.
A hammertoe occurs when the toe bends or curls downward, causing the proximal joint to protrude. Dr. Sharma explains that there are several types: “A hammertoe is the contracture of the proximal joint, the one closer to the base of the foot. A mallet toe is a contracture of the distal joint, or bending at the tip of the toe. Then there’s a claw toe, which is a combination of both.”
While many believe shoes are always to blame for hammertoes, Dr. Sharma notes that heredity often plays a larger role. Hammertoes can also result from tendon imbalances within joints: “There are opposing tendons per toe that are responsible for flexion and extension… When the flexor tendon overpowers the extensor tendon, it can form hammering of the toe.”
Treatment options vary depending on whether surgery is desired and on whether the hammertoe is flexible or rigid. Conservative treatments exist but may not prevent recurrence. Surgery decisions depend on flexibility: “If you opted for surgery, it must first be determined if the hammertoe is flexible or rigid… one of the best options is an arthrodesis procedure, or fusing the joint,” says Dr. Sharma. This involves removing cartilage and using pins to hold position until fusion occurs—a process that typically results in less recurrence.
For flexible hammertoes, procedures such as flexor tenotomy or arthroplasty may be considered but have higher rates of recurrence compared to fusion: “Nine times out of 10, she’s fusing the joint for hammertoe repair to prevent recurrence,” Dr. Sharma states.
Corns often develop alongside hammertoes as thickened areas caused by friction or pressure—frequently from ill-fitting shoes or abnormal bone positions in feet due to genetics or physical activity levels like running. According to Dr. Sharma: “They are both extra tissue that your body has formed to create like a band aid to help prevent breakdown of soft tissue.”
Treatment typically involves shaving down corns with routine care being especially important for people with diabetes because untreated corns can lead to ulcers or infections—and potentially amputation if ignored.
Dr. Sharma cautions against over-the-counter pads containing salicylic acid since they may worsen problems; instead she recommends prescription creams between shavings but notes shaving does not cure unless underlying structural issues are surgically addressed.
She emphasizes proper footwear selection—considering both width and height of shoe boxes—to minimize risk: “Turn your shoe to the side and see how high your shoe box is… Make sure you actually have room for your toes to move and breathe.”
Wearing appropriate shoes based on activity level remains key advice from Dr. Sharma; while sandals might be suitable at beaches short trips should prompt consideration of supportive tennis shoes instead.
