HealthInfo Waitaha Canterbury
Mallet toe
Matiwae kuru
Mallet toe is like hammertoe, but it affects different joints. If you have mallet toe, one or more of your toes bends down abnormally from the joint closest to the tip of your toe. In hammertoe the bend happens at the middle toe joint.
Mallet toe can affect your big toe, second, third or fourth toe. It can be painful and disabling.
Causes of a mallet toe
Several things can lead to mallet toe. They include:
- shoes that are too small or that squeeze your toes, such as high heels
- genetics (it can run in families)
- an injury that jams or breaks your toe
- diseases that affect your nerves and muscles, such as arthritis
- nerve or muscle damage that affects the way your foot works.
Your risk of getting mallet toe increases as you get older. It's more common in women than in men and having a second toe that is longer than your big toe may also increase your risk.
Symptoms of a mallet toe
The symptoms that suggest you're developing mallet toe include:
- pain in your toe, often when your foot moves
- a stiff toe
- corns and calluses
- a toe that is stuck in a bent position.
If you can still straighten your toe, it's called flexible mallet toe. If you cannot move it at all, it's called fixed mallet toe.
Pressure on the top of the toe joint can cause irritation. You may develop a corn on the top of your toe, and a callus on the bottom.
Corns and calluses can become painful and cause extra symptoms, such as redness, bleeding and difficulty wearing socks and shoes.
Preventing a mallet toe
The best way to avoid mallet toe is to make sure you wear shoes that fit you properly. Podiatrists suggest you get your feet measured properly. Then, when buying shoes:
- make sure there is a centimetre of space for your longest toe at the end of each shoe when you're standing
- shop at the end of the day, when your feet are the most swollen
- buy shoes that fit your longest foot
- always try shoes on before buying and make sure they're comfortable and have plenty of room. Shoe sizes vary by brand, so they aren't a reliable guide
- make sure the tops of the shoes do not rub on your toes
- avoid shoes with pointed toes, or slip-on shoes that have no back strap (for example, jandals)
- buy wide shoes with good shock-absorbing soles.
Limit how often you wear high heels and do stretches and exercises such as picking up objects with your toes to keep them flexible.
When you're buying shoes for tamariki (children), make sure the shoes are fitted properly, especially at times when the tamariki are growing rapidly.
You can prevent many foot problems by following a few simple steps:
- wear comfortable shoes that fit properly, and avoid shoes that are too narrow
- wear shoes that are appropriate for your type of work and sport
- check your feet and toes regularly for any skin changes or deformities
- see a podiatrist if you have pain in a foot or toe
- stretch your foot daily to strengthen the muscles.
Treating a mallet toe
As long as mallet toe is not painful or changing the way you walk, it doesn't need to be treated.
Treatment focuses on relieving the pressure under the tip of your toe. You may need special footwear that has extra depth around the toe to alleviate this pressure.
Seeing a podiatrist for orthotics or toe protectors can often help. If the joint is still mobile (not fixed), physiotherapy can also help. You can find a podiatrist by searching on the Podiatry NZ website. You can find a physiotherapist by searching on the Physiotherapy NZ website.
Occasionally, if podiatry and physiotherapy have not improved your pain, you may need surgery. This is unlikely to be covered by the public health system, but you may ask your general practice team to refer you to a private orthopaedic surgeon.
If your mallet toe happens after an injury, this might be treated with plaster. See your health professional to check if you need any treatment.
Written by HealthInfo clinical advisers. Last reviewed April 2023.
SourcesReview key: HICCA-28239
