The symptoms of these conditions are toes that appear curled under to varying degrees. Hammer, claw, and mallet toes are variations of deviant toe malformation that are neither genetic nor trauma-based.

What causes these conditions?

Hammer, claw, and mallet toes are usually caused by an imbalance of the flexor and extensor muscles at the relevant joints especially when one muscle group overpowers the other. This often happens when unhealthy footwear is worn for extended periods.

There are two muscle groups that control joint movements:

  • Flexors cause the toes to bend downward
  • Extensors cause the toes to rise

These two muscle groups naturally oppose each other but, when they work together, they produce a balanced tension that keeps the joints properly aligned.

They are further subdivided into two muscle types:

  • Intrinsic muscles, which are the small muscles in the foot. These muscles are involved in finer movements.
  • Extrinsic muscles, which are muscles in the lower leg that are connected to the foot via long tendons. These muscles help stabilize the foot during weight bearing activities.

These conditions occur as a result of intrinsic muscle activity attempting to create a proper functioning arch when the foot’s extrinsic muscles have failed to do so.

Hammer Toes
Hammer Toes Front
Hammer Toes Back

For proper function, our feet require the Right Stimulus and the Right Movement.

Right Stimulus consists of the subtle varied stimulus that the soles of our feet receive when we walk, especially when we walk barefoot on natural terrain. With each step, there are subtly different sensations.

These subtle differences in stimulus keep our brain on high alert so that our body’s protective reflexes function properly with optimal muscle function.

When our brain is uncertain about what will happen, it triggers protective reflex muscles activations that support our arches before our feet contact the ground to ensure that our feet and legs can safely manage the forces generated by our bodies relative to activity intensities.

As activity-related stimulus intensifies, a progressively higher arch is created. That’s why, when they are functioning properly, our arches and toes rise and fall dynamically in response to the varying activity stimulus intensities. This uninhibited dynamic movement is Right Movement.

Right Stimulus and Right Movement prevent the imbalanced muscle function that contributes to the formation of hammer, claw, and mallet toes.

Right Stimulus
Toe Raise Beach

Conventional footwear impairs optimal foot function in two ways:

First, most conventional footwear dampens Right Stimulus.

This is particularly true for shoes or insoles that support or cushion our feet. They spread the forces evenly across the soles of our feet, creating sensory input that’s muted and repetitive, step after step. Within a short period of time, our brain tunes out the stimulus and stops responding to it.

As a result, our brain doesn’t sufficiently activate the muscles that stabilize our arches and properly align our feet, legs, hips, and lower back, before our feet contact the ground. This “tuned-out” brain response is natural and happens all the time. For example, the same thing happens when we walk into a room and first smell coffee that becomes unnoticeable after only a few minutes.

Soft Cushy Insole

Second, most conventional footwear – especially footwear that is tightly laced with snug toe boxes or stiff midsoles or outsoles – restricts the Right Movement dynamic raising of the arches and toes that is critical in the creation of a strong stable arch system and healthy linear propulsion with the toe off forces spread across the forefoot.

In many cases, when Right Stimulus and Right Movement are impeded, our intrinsic muscles may attempt to stabilize our arches when our feet contact the ground. However, this is a function they are not capable of performing, which makes them vulnerable to inappropriate forces and action. The result is an imbalance in specific muscles that can lead to the formation of hammer, claw, and mallet toes.

Conventional treatment methods for hammer, claw, and mallet toes include:

  • Taping
  • Supportive products such as orthotics
  • Toe separators and
  • Surgery
Hammer Claw Mallet Toe

While these methods may temporarily alleviate symptoms, they don’t address the poor neuromuscular function that is the cause of the problem. In fact, the more we artificially support or cushion our feet, the weaker and the more dependent we become on these types of products.

These “old school” support and cushioning treatment methods are not recommended in any other area of musculoskeletal medicine as a viable long-term treatment option.

In fact, today’s modern treatment methods for poor neuromuscular function focus on increasing mobility, muscle strength, and proper alignment via Proper Technique exercise, which requires both Right Stimulus and Right Movement. Science has shown that simply challenging the body to “do its job” is the best way to restore and enhance function.

This principle is the foundation for virtually all of today’s sports training/rehabilitation programs.

Recommendations to address the poor neuromuscular function that causes
hammer, claw, and mallet toes and prevent them from reoccurring:

  • Walk barefoot on natural terrain as much as possible. This provides the optimal Right Stimulus and allows for the Right Movement required for healthy neuromuscular function.
  • To attain Right Stimulus in your conventional footwear, use BioPods® Stimsoles® and, for best results, use them in loosely laced, soft, flexible footwear that allows your arches and toes to rise easily.
  • Consult with your healthcare practitioner to ask about employing soft tissue mobilization therapies to address the fibrotic scar tissue that may have formed, prior to using BioPods products.