If the joint in one of your toes, usually the toe next to the big toe or the smaller big toe, points up rather than straight, you may have hammertoe. The condition is a deformity that occurs when one of the muscles in the toe weakens and puts pressure on the tendons and joints of the toe. This pressure forces the tip to deform and stick to the joint.

In addition, there is often a callus or callus above the deformed toe. This growth can cause pain when it rubs against the shoe. The term hammer toe is commonly used as a general classification for any condition in which the muscle of the big toe becomes weak, causing digital contracture and subsequent deformity. A digital contracture like this can be hammer toe, claw toe, or hammer toe, depending on which toe joints are contracted.

The toes are bent at the middle and terminal joints, while hammertoes are bent only at the middle joint. When it comes to hammer toe, the joint at the fingertip’s bends. The skin near the tip of the nail develops a painful corn which can eventually lead to an ulcer. Physicians further classify all forms of hammer toe according to whether the affected tip is flexible, semi-rigid, or rigid. The stiffer the tip, the more pain it will cause.


A hammer toe occurs when the muscles and ligaments around the toe joint become out of balance. This causes the central ball joint of the ball of the foot to collapse and lock in this position. It is very likely that you will see a hammer toe in the middle three fingers. Toes that curl are also hammer toes. This most often happens with the baby’s toes.

Kinds of Hammertoes You Would Have

There are two types:

Flexible Hammertoes

If you can still wiggle your big toe at the joint, it’s a flexible hammertoe. Agree, because that means you have a milder form of the problem. There may be several treatment options.

Rigid Hammer Toes

If the tendons in the toe become stiff, they push the joint out of alignment. At this point, you cannot move your big toe. This usually means you need surgery.

Hammerhead Big Toe Symptoms

The main big toe symptom is one or more toes that appear to be bent upwards in the middle. Because of those pinched toes, you may have: 

  • Blisters and calluses where your toes rub against the top of your shoes 
  • Pain in the toe joint where it meets your foot 
  • A pain when walking 
  • Stiffness of bent toes that gets worse over time

The Anatomy You Need to Know

The forefoot is made up of five fingers. Each toe has three joints, except for the first (big toe), which usually has only two joints. In hammertoe, the affected toe is bent at the central joint, called the proximal interphalangeal (PIP) joint.

What Causes Hammertoe

Hammertoe is the result of a muscle imbalance that puts pressure on the tendons and joints of the fingers. The muscles work in pairs to straighten and bend the toes. If the toe is bent in one position long enough, the muscles and joints contract and cannot stretch.

Wearing ill-fitting shoes is a common cause of this imbalance. Shoes that taper towards the toe push the smaller toes into a flexed (bent) position. The toes rub against the shoe, causing corns and calluses to form, further aggravating the condition. Shoes with a higher heel push the foot down and push the toes against the shoe, increasing the pressure and curvature of the toe. Eventually, the finger muscles can no longer straighten the toe.

Risk Factors You Need to Know

The muscles in each toe work in pairs. When the toe muscles lose their balance, a hammertoe can form. Muscle imbalance puts a lot of pressure on the tendons and joints of the big toe. This pressure forces the big toe into a hammer-like shape.

What Causes Hammertoe?

  • Shoes that don’t fit. If your shoes are too tight, too short, or too pointy, they push your toes out of balance. Pointy, high-heeled shoes put particularly severe pressure on the toes.
  • Arthritis
  • Alcoholism
  • Charcot-Tooth-Marie disease, a disorder that damages the nerves in your arms and legs
  • Spinal cord tumours
  • Polio
  • Stroke
  • High arches
  • Feet that rotate inward when you walk
  • Bunions

Furthermore, your risk of suffering from hammertoes would increase with – 

  • Flat feet
  • Genes – You may have inherited conditions or features that make your feet unstable.
  • Age
  • Long toe bones – If your second toe is longer than your first, it’s at a higher risk of hammertoe.

Women are more likely than men to suffer from hammertoes due to the type of shoes they wear. Hammertoes can be a serious problem in people with diabetes or poor circulation, as they are at higher risk for foot infections and ulcers. Custom-made orthopaedic shoes can prevent these complications. People with these conditions should see a doctor at the first sign of foot problems.

Diagnosis of Hammertoe

Your doctor should be able to tell if you have hammertoes by looking closely at your feet and asking you about your symptoms. If they want more detailed information about your foot and toe joints or bones, you may also get an Xray.

The Complications Involved

If not treated in time, the person may start limping to relieve the discomfort. This shifts body weight in unusual ways, causing other orthopaedic problems. The deformed toe begins to rub against the top of the shoe, causing corns, calluses, hallux valgus, redness or swelling. These sores can develop infection and pus formation.

If you have diabetes or peripheral arterial disease, infected wounds can lead to conditions such as cellulitis or osteomyelitis. Due to the unsightly appearance of the feet, the person may avoid social gatherings. When social gatherings cannot be avoided, the person tends to push their feet back and out of sight while seated. This puts pressure on the knees.

Treatment You Can Follow for Hammertoe

To relieve several the signs and symptoms of hammertoe, your health practitioner might also additionally suggest:

  • Roomier footwear that enlarge as a minimum a 1/2 of inch beyond your feet
  • Inserts or pads for your footwear that reposition your feet to alleviate ache
  • Special sports that extend and give a boost to your feet
  • Taping or splinting your toe to make it straight
  • Ice packs for your feet to alleviate ache and swelling
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) consisting of ibuprofen or naproxen to assist with ache and swelling

If your hammertoe is severe, you could have surgical operation to accurate it. It can be a choice in case your ache has gotten very bad, your toe could be very rigid, or you’ve got an open sore due to your hammertoe.

There are several surgical options: 

  • Arthroplasty: A surgeon takes half of the joint under each twisted finger so it can lie flat. 
  • Arthrodesis: A surgeon removes the entire joint under the twisted toes and inserts a wire to help straighten it while it heals. 
  • Tendon Transfer: A surgeon attaches the tendons under the big toe to the top of the big toe to help straighten it. 
  • Basal Phalangectomy: A surgeon extracts the base of the bone under the hammer toe. 
  • Weil Osteotomy: A surgeon shortens some bones in your foot and then puts screws in them.

Treatment for Hammertoes

Nonsurgical Treatments

In the early phases of the hammer tip, when the articulation is still flexible, the treatment is generally made up of simple measurements.

Changing Shoes

Your doctor will advise you to avoid wearing tight, narrow, and high-heeled shoes. Shoes should be half an inch longer than your longest toe, which for many people is the second toe, and have a soft, roomy toe.

You can also find a deep toe shoe that contains the hammer toe. A cobbler might be able to stretch a toe so that it swells around the toe. Wearing sandals can help if they don’t pinch or rub other areas of the foot.


Specific exercises can help stretch and strengthen the muscles of the foot. Your doctor may recommend that you gently stretch your toes manually or use your toes to pick things up off the floor. He may also recommend doing “towel curls” to strengthen the toes. To perform a towel curl, place a flat towel under your foot and use your toes to curl it.

Over-The-Counter Remedies

Using commercially to be had straps, cushions or nonmedicated corn pads can assist relieve pain. If you’ve got diabetes, negative circulation, or a loss of feeling to your feet, speak in your medical doctor earlier than trying any self-treatment.

Surgical Treatment

If the toe joint is inflexible and not moveable, or if nonsurgical remedy does now no longer relieve your symptoms, your physician may also suggest surgery. Surgery is commonly accomplished on an outpatient foundation the usage of a neighbourhood anaesthetic. The real system will rely upon the kind and quantity of the deformity.

Tendon Lengthening

For sufferers with a bendy toe joint, the situation can regularly be handled through lengthening the tendons which can be inflicting the joint imbalance.

Tendon Transfer

Some sufferers with a bendy toe joint may also advantage from remedy that includes shifting tendons from the lowest of the toe to the pinnacle of the toe to assist pull the joint right into an instantly position.

Arthrodesis (Joint Fusion)

Patients who’ve an inflexible toe joint may also go through tendon lengthening in aggregate with arthrodesis. In this system, your physician will eliminate a small a part of a bone withinside the toe joint to make certain that the toe can amplify fully. He or she can be able to then insert an outside cord or pin and/or inner plate to preserve the bones in location at the same time as the bones fuse together.

Treatment for a Mild Hammer Toe

You can correct hammertoe caused by improper footwear by wearing the correct size shoes. If a high arch has caused the condition, wearing toe guards or insoles in your shoes can help. These pads work by shifting the position of your toe, which relieves pain and corrects the appearance of your toe.

You can usually use pillows, sanitary napkins, or over the counter (OTC) medications to treat bunions and calluses. However, if they are painful or cause toe deformity, your doctor may choose to have them surgically removed.

Don’t blister your toes. Bursting blisters can cause pain and infection. Use over-the-counter creams and pillows to relieve pain and keep blisters from rubbing against the inside of your shoes. Gently stretching the toes can also help relieve pain and reposition the affected big toe.

Treatment of Severe Hammertoe

If you are unable to flex the toe, surgery is the only option to restore movement. Surgery can reposition the big toe, remove misshapen or injured bone, and realign tendons and joints. The surgery is normally done on an outpatient basis, so you can go home the day of the surgery.

Over-The-Counter Merchandise May Also Assist Lessen Pain

If you’ve got evolved corns or calluses in your foot due to the hammer toe, there are over the counter (OTC) merchandise that guard and shield the pores and skin. A podiatrist or foot and ankle health practitioner may also advocate a particular kind for you and can provide you with a warning towards the use of OTC pads which have medicinal drugs in them. These may also look like an awesome concept to assist control the difficult or raised pores and skin areas, however they may be dangerous for a few human beings, particularly human beings who’ve diabetes. There also are unique orthotic gadgets you may put on your shoe that push your feet in an extra herbal position.

Don’t Laugh: Hammer Toe Exercises Are One Thing

Exercising the toes to move in the direction they are supposed to help strengthen muscles and encourage the toes to lie down naturally. The main exercise is to bend the toes and then spread them, then move them. The best way to curl them is to try picking up things, like a pencil, or crumpling a cloth under your toes, then picking it up with your foot. This exercise also helps keep the toe joints flexible.

You can usually manage pain and stiffness with medication or injections. If over the counter and orthopaedic products don’t help, your doctor may recommend a corticosteroid injection. Injecting the medicine directly into the affected big toe may help relieve inflammation and allow you to move your big toe more easily. The movement of the toe, in turn, activates underused muscles and tendons. Over the counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs) can also be helpful in relieving inflammation and pain. Some people get relief by applying ice to the tip but be sure not to put ice directly on the skin – wrap the ice to avoid damaging the skin from the cold.


Saravavan Nadarajan (Vanan)

Vanan, fitness expert and leader at EzFit Singapore, specializes in holistic training—home-based, boot camps, and corporate fitness—with over a decade of industry experience.

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