Mallet Toes: Symptoms, Causes & Treatment
Nov 15 , 2021
Tags - Mallet Toes
We all use our feet a lot.
And daily wear and tear can cause toe pain on the odd occasion; that’s normal.
But, developing mallet toes is completely different, as it can cause issues when wearing shoes as well as causing discomfort even when doing basic everyday activities.
So, what exactly is a mallet toe?
To put it simply, it refers to an upward bend at the joint of the toe, and sometimes it can cause the toe to look curled rather than flat.
Typically, mallet toe happens in the second toe (next to the big toe), because it’s often the longest, but it can affect the other toes too.
To explain this further, mallet toes involve two parts of the body: the distal interphalangeal joint (DIPJ), which is the joint closest to the toenail, and the flexor digitorum longus (FDL), which is the muscle that helps the toes curl and starts by the shin and runs down to the smaller four toes.
And, when this muscle becomes too tight, it causes the toe joint to bend upwards.
Further, there are two types of mallet toes:
- Flexible: this is where the muscle and the joint in the toes are still able to move
- Rigid: this is where the muscle and tendons become tight and freezes the joint in a bent position
Sometimes, mallet toes are confused with hammer toes, and even though both conditions affect the joints in the toes, the biggest difference is that mallet toes bend in the third joint closest to the nail, whereas hammer toes affect the second or middle joint.
Symptoms
First of all, you’ll know you have developed a mallet toe if there is an obvious curl or bend at the joint nearest to the toenail.
But other symptoms include:
- Redness
- Swelling
- Corns or calluses on the bent part of the toe
- Pain when wearing shoes or walking
- Sores or ulcers, especially in people with diabetes
- Thicker toenail or changes in colour
Causes
The biggest cause for mallet toe is when the toes are constantly forced upright.
However, other common causes include:
- Arthritis
- Bone or muscle imbalances; e.g. the bones are too short or the muscles are too weak
- Injuries
- Tight shoes
Essentially, all of these causes place added pressure on the tip of the toe, which results in the deformity.
In addition, there are certain risk factors associated with mallet toe: women are more likely to develop the condition and the risk increases with age.
Treatment
Fortunately, most people can find relief with conservative treatment; i.e. they don’t need surgery.
Generally, if the mallet toe is flexible, you may be recommended to:
- Gently exfoliate any calluses to smooth them down
- Apply toe pads on corns and calluses to reposition the toes
- Use steroid injection to reduce inflammation
- Toe stretching exercises, such as picking up a towel or marbles with your toes
- Insert customised orthotics to relieve pressure from the toe
- Wear shoes with extra room in the toe box
On the other hand, if surgery is recommended it will focus on releasing the tendon that is causing the bend in the joint.
Or, removing the bone completely to straighten the toe (known as arthroplasty or phalangeal head resection).
Furthermore, there is an option of a joint fusion (arthrodesis), which involves removing part of the joint which allows the bones in the toe to grow together; this tends to be the most common form of surgery.
Keep in mind, as with any foot surgery, it is very common for swelling to persist for a few months, and this is completely normal. It should subside with time and in some cases can take up to 12 months to fully heal.
The Bottom Line
As obvious as it sounds, taking good care of your feet can help to prevent mallet toes from developing.
And so, you should avoid wearing shoes that are too tight and pinch your toes as well as choosing footwear with a relatively low heel to ensure there is no added pressure placed on the toes.
However, should mallet toes develop, be sure to seek professional advice.
For more information, please get in touch today.
In the meantime, take a look at our full range of comfortable shoes here.
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