Sometimes a muscle imbalance causes a hammertoe, or a bending of the toe at the first joint.


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Introduction - Hammertoe

Sometimes a muscle imbalance causes a hammertoe, or a bending of the toe at the first joint. The bent toe looks like an upside-down “V”. The abnormal imbalance of muscles increases the pressure on the toe’s joints and tendons.

A flexible hammertoe is still moveable at the joint and can be treated, but a rigid hammertoe may become immobile.

Trauma such as from an injury can cause a hammertoe, as can heredity, arthritis, and wearing shoes that are too tight.

Problems With Your Little Toes

Your little toes help balance and propel your body when you move. As your foot flattens, the little toes bend to grip the ground. Then they straighten, acting like levers to help push your foot so you can walk, run, or dance. But if the front of your foot is wide, you may develop a problem known as a hammer toe. Hammer toes are the little toes that buckle or curl under. Over time, these toes may hurt and make movement more difficult. But you don’t have to live with pain. With your doctor’s help, even severe hammer toes can usually be treated so you can move more easily.

What Are Hammer Toes?

In general, the term “hammer toes” describes a buckling of any of the toe joints. Joints at the end or middle of the toe, as well as the joint near the ball of the toe, may be affected. Toe joints usually curl because of a muscle imbalance or tight tendons. Hammer toes vary in severity and in the number of joints and toes involved.

Types of hammer toes

Hammer toes may be flexible or rigid, depending on the joint’s ability to move. A flexible joint may become more rigid as you age.

A Flexible Joint

You can straighten a flexible hammer toe with your fingers. Although they look painful, flexible hammer toes may not hurt.

A Rigid Joint

A rigid hammer toe cannot be moved, even with the fingers. Rigid joints may cause pain and distort foot movement. This may put extra stress on the ball of the foot, causing a callus (a corn on the bottom of the foot).

Hammertoe Symptoms

Symptoms of a hammertoe include:

  • Pain at the top of the toe because of shoe pressure
  • Corns on top of the bend
  • Swelling and redness of the joint
  • Restricted motion of the joint
  • Pain extending to the ball of the foot at the base of the hammertoe

Hammertoe Treatment

You can relieve the discomfort of a hammertoe by padding the area to reduce friction. Switch to shoes with a deep, wide toe box and avoid high heels. Icing can help with inflammation.

But a hammertoe cannot be cured without professional help from a podiatrist.

To confirm our diagnosis, we will take an X-ray of the area. Treatment options include:

  • Padding and taping to minimize pain and relieve stress.
  • Anti-inflammatory medications and/or cortisone injections to reduce pain and inflammation.
  • Custom-fitted orthotics to reduce symptoms and prevent worsening of the deformity.

There are several surgical options if necessary.

Physical Exam

Your doctor will examine all your toes, testing whether or not buckled joints can be moved. Your feet will also be checked for any skin changes. Corns (a buildup of deadskin cells) often form between curled toes or on top of buckled joints where shoes rub. If irritated, corns may turn into open wounds and become infected.


X-rays may be taken of a curled toe to show the amount of deformity. An x-ray may also show whether or not the joint is affected by arthritis.


If your symptoms are mild, changing shoes may be all the treatment you need. Using a splint or pad to hold your toes straight also may help. Or try cushioning corns and calluses with felt padding. If your symptoms are severe, surgery may be needed. The type of procedure often depends on whether your toe joints are flexible or rigid.

Flexible Joints

To release a buckled joint, the tight tendon (often the bottom one) is cut and repositioned.

Rigid Joints

A piece of bone may be removed to help straighten a rigid toe. Two surgical examples are described below. With either surgery, a pin may be used to hold the remaining bone in position during healing. With arthroplasty, part of the curled joint is cut away. The “gap” fills in with fibrous tissue. With fusion, the joint cartilage is removed. The toe bones heal as one longer bone.

After Surgery

Almost all hammer-toe surgeries are outpatient procedures. In fact, you may even be able to bear weight on your foot by the time you get home. For best results, however, you may need to wear a surgical shoe for several weeks.

The First Few Weeks

Your foot will be bandaged after surgery, and you may need to wear a surgical shoe to support the foot during healing. Your doctor may recommend a special dressing to limit swelling. Elevation and ice can also help. For best results, raise your foot above heart level and apply ice for 15 to 20 minutes. Protect your skin by placing a towel between the ice pack and your skin.

Proper Shoes

Help make surgery a success by wearing shoes that fit your feet. Shoes should be long enough and wide enough to keep all your toes comfortable.

Hammertoe Prevention

You can prevent hammertoes from forming or getting worse. Wear supportive shoes and avoid those with pointed or narrow toe boxes. Orthotics can help prevent the development of hammertoes or slow their progression.