Written by Meredith Grace Merkley, DO, FAAP | Reviewed by Patricia Pinto-Garcia, MD, MPH
Key takeaways:
A hammertoe happens when a toe is stuck in a bent position at the middle joint. It can be painful and cause trouble with walking and other activities.
If you’re at a higher risk of developing a hammertoe, wear shoes with wide toe boxes, and avoid shoes that are narrow, tight, and heeled.
Treatment options for hammertoes include stretches, taping, exercises, and surgery.
A close-up image shows a foot with a hammertoe.PAUL CAMPBELL/iStock via Getty Images Plus
Your toes help you move and keep your balance. But daily wear and tear can take a toll on the small, delicate bones and joints that form your toes.
A hammertoe is a type of toe deformity where the middle joint of a toe is stuck in an upward bend. Because the joint is stuck in this position, the top of the toe is bent forward so that it looks like a hammer.
The joints in your toes let each toe bend forward (also known as “flexing”). The muscles on the top of your foot help to stretch out and straighten your toes. And the small muscles on the bottom of your foot help to bend your toes.
When the small muscles on the bottom of your foot (intrinsic muscles) are weaker than the larger muscles on the top of your foot (extrinsic muscles), your toe can get stuck in an upward bend at the middle toe joint. But a hammertoe affects more than just how your toe looks — it also can cause pain when walking and affect your balance.
If you have a hammertoe, there are several options that can help relieve your discomfort. Let’s take a look at hammertoes and what you can do to take care of your toes.
What are the symptoms of a hammertoe?
If you have a hammertoe, you’ll notice that your toe is stuck in a bent position at the middle joint. The tip of your toe will point down into the sole of your shoe. It looks like you’re curling just one toe — but you can’t relax it.
Hammertoes can lead to other toe symptoms, like:
Swelling or redness over the toe
Corns or calluses on the toe, especially where it rubs against shoes
Pain with walking
Changes in balance
A shift or change in gait
Hammertoe vs. claw toe vs. mallet toe vs. bunion
Hammertoes are only one of several conditions that can affect your toes. Other common toe deformities include claw toes and mallet toes.
Claw toes develop when your toe gets stuck in a bent position at your first toe joint. Mallet toes develop when your toes get stuck in a bent position at the third toe joint. It’s possible to develop a claw toe or mallet toe along with a hammertoe.
Bunions are a different type of foot condition. They develop at the base of the great toe and can also cause pain, redness, and trouble walking. People who are prone to bunions are also prone to developing hammertoes. This is because the great toe shifts toward the smaller toes when someone develops a bunion.
What causes a hammertoe?
Some people are more likely to develop a hammertoe. Here are some things that increase the risk of developing a hammertoe.
Foot shape
Some people are more likely to develop hammertoes because of the natural shape of their feet. People with flat feet and longer metatarsals (the middle bones of your feet) can develop hammertoes because of how their feet muscles naturally work to maintain balance when walking.
People with hallux valgus — a condition where the big toe points inward instead of straight — are also more likely to develop hammertoes. If your second toe is longer than your great toe, you may also be more likely to develop a hammertoe.
Medical conditions
Certain medical conditions can also increase the risk of developing hammertoes. Any medical condition that affects the muscles, tendons, or nerves in the feet can change how you walk or position your feet and toes to maintain balance. Over time, these subtle changes can lead to hammertoes.
Medical conditions that increase the risk of developing hammertoes include:
Diabetes
Rheumatoid arthritis
Osteoarthritis
Psoriatic arthritis
Peripheral neuropathy
Neuromuscular disorders
Shoes
Wearing the wrong kind of shoes can also increase your risk of developing a hammertoe. Shoes that don’t fit right can put pressure on the tip of the toe. And shoes with heels can force the toes down into the tip of the shoe.
This causes the extrinsic muscles to pull up at the middle joint so you can maintain your balance. If your toes stay in these positions for a long time, the tendons and muscles of the small toes are more likely to stay in that position all the time — even when you’re not wearing shoes.
Injuries
Foot injuries can also increase your risk of developing hammertoes, especially if they’ve affected the muscles, tendons, or bones in your feet. A broken foot or toe can lead to hammertoes. The same is true for foot and ankle surgeries, especially if you’ve experienced a change in your gait afterward.
At-home treatments for hammertoes
There are several things you can do to relieve the pain and pressure from your hammertoes and even get it closer to looking straight. You can do these treatments at home using basic supplies from your local pharmacy.
Use these treatments as soon as possible. Early on, your toe joint is still flexible, so the treatments are more likely to work. Once the joint becomes stiff, these methods won’t change how your toe looks and may not help relieve pain and pressure.
Footwear swaps
Wearing the right shoe is one of the most important things you can do for your toes. The right footwear will put less pressure on your toes, giving them room to straighten out. Opt for shoes that have wide toe boxes. Clogs, sandals, and many types of sneakers have roomier toe boxes. You can also search for shoes labeled as “wide fit.” Avoid heels and tight or narrow shoes as much as possible.
Toe exercises
Hammertoes develop when the extrinsic muscles in the foot are stronger than the intrinsic muscles in the foot. You can relieve pressure on your toes by building up the strength of the intrinsic muscles of your foot. Toe exercises can help you do this.
Try picking up and dropping marbles (or any small, round object) with your toes. You can also try gentle toe exercises, like towel curls. Try doing these exercises every day for 5 to 10 minutes.
Toe cushions or pads
Toe cushions and pads are available over the counter at local pharmacies. You can place pads over corns, calluses, and bunions. They stop these areas from rubbing against your shoes. This helps ease the pressure on your corns, calluses, and bunions. In turn, this will ease the pressure on your hammertoe.
You can also try insoles and arch support if you have flat feet. This will relieve pressure on your toes, which will help your hammertoes.
Some of these items may be FSA and HSA eligible.
Tape
You can help stretch your toes by using toe splints and kinesiology (medical) tape. Toe splints and kinesiology tape are available over the counter at most pharmacies and at runner stores. There’s some evidence that taping your toes in a natural position can help stretch them over time. You can tape your toe into a natural position overnight and remove the tape in the morning.
Hammertoe surgery
If your hammertoe isn’t flexible anymore — meaning you can’t straighten it easily and without pain — you may need toe surgery to fix your toe and relieve pain and pressure. Common surgeries include:
Tendon release
Tendon transfers
Joint fusions
These procedures are usually quick and can be done in your podiatrist’s office. Most people only need local anesthesia, which means you don’t have to worry about the risk of general anesthesia.
Studies show that these procedures significantly improve symptoms for people with non-flexible hammertoes.
The bottom line
A hammertoe describes a toe that is stuck in a bent position at the middle toe joint. Hammertoes can cause pain and balance issues. Some people are at higher risk of developing them. If your hammertoe is still flexible, treatment options include stretches, exercises, taping, and properly fitting shoes. If your hammertoe is fixed, surgery may be the only treatment option. It’s a good idea to work with a podiatrist to find the right tools and support for your hammertoe.
References
Doty, J. F., et al. (2018). Treatment of rigid hammer-toe deformity: Permanent versus removable implant selection. Foot and Ankle Clinics.
Goransson, M., et al. (2023). Hammertoe. StatPearls.
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