Are Hammertoes and Bunions Connected?

 When it comes to foot problems, especially those that change the shape and alignment of your feet, hammertoes and bunions are far and away the most common.

Bunions, alone, affect about 1 in 5 people, and hammertoes account for about 20% of foot deformities. While these two issues certainly stand alone for many, just as many people find that they occur together, essentially doubling down on the foot problem.

As experts in foot health, Dr. Lisa Shah, Dr. Mariola Rivera, and the rest of our team here at Aesthetic Podiatry & Sports Medicine Center have certainly seen our fair share of bunions and hammertoes, separately and together.

In the following, we dive into how bunions and hammertoes can be connected and how we can help correct both common foot issues.

Bunions and hammertoes — matters of alignment

Most people look at a bunion and think that it’s just a matter of some extra bone growth that’s pushing the big toe outward. The reality is that the bony bunion is a result of an alignment problem inside the joint.

More specifically, a bunion first starts in the joint at the base of your big toe — the metatarsophalangeal joint (MTP) — which joins the long metatarsal bone with the first small phalanx bone in your toe. 

When there's a misalignment in your MTP, the metatarsal bone starts to shift toward the inside of your foot, which pushes the phalanx toward the outside. In response, your body produces more bone in the joint to fill in the gap of the misalignment, creating that noticeable bunion.

About 70% of bunions are hereditary, while the balance often comes from footwear — for example, shoes with heels and pointy toes that throw off the balance in your feet.

Now, let’s move over to hammertoes, which typically occur in the second and third toes in your feet. 

In technical terms, hammertoes occur when there’s an imbalance between the intrinsic and extrinsic muscles surrounding the MTP joints in your smaller toes. As a result, the stronger extrinsic muscles pull the joint upward, bending your toe into a hammer shape.

Connecting the dots between bunions and hammertoes

If you have both bunions and hammertoes, it’s likely that the bunions appeared first (though this order isn’t set in stone). As the misalignment in the MTP joint in your big toe progresses, it throws off the alignment in the rest of your toes, leaving you far more susceptible to hammertoes.

Treating hammertoes and bunions

There’s good news and bad when it comes to hammertoes and bunions, and we’ll start with the bad. There's nothing you can do to reverse any existing deformity once it forms. However far along your bunion or hammertoe is, it stays that way (and often gets worse) unless you take action.

If the hammertoe and bunion are mild, we can take steps to slow their progression through orthotics, changes in footwear, and foot exercises.

If the foot problems continue to progress (or they’re already fairly significant), we can hit the reset button on both bunions and hammertoes through surgery.

We perform both surgeries on an outpatient basis, as we’re able to use advanced, minimally invasive techniques that will have you up and moving around in no time.

If you have more questions about bunions and hammertoes, we’re here to help. To get started, book an appointment online or by phone at one of our offices in Purchase or White Plains, New York.