If the ends of your toes resemble more of a hammer than they do straight toes, then it sounds like you may have developed a hammertoe deformity. Hammertoes curl through at the middle of the toe before straightening again at the tip. This is similar to claw toes, with the difference being the tips of claw toes keep pointing down towards the ground, and mallet toes, where the toe remains straight until the tip which points downwards.


Here is a great illustration of these differences from Advanced Foot & Ankle.


What causes a hammertoe?


As you can see in the illustration above, each of your toes has two joints between three bones – aside from the big toe which only has one joint between two bones. Hammertoes develop when abnormal forces or pressure on the toes or force the joints into a bent position for prolonged periods, leading to permanent changes to the joints and the muscles and ligaments surrounding the joints. The muscle or tendon imbalances may also be caused by neurological factors, like nerve damage and certain medical problems including arthritis.


The most common causes for pressure on the toes are tight, narrow or poorly fitting footwear that cramps the toes and forces them back into a hammer-like position. Having a long second or third toe is also a common factor, as most people measure their shoes to their big toe without thinking that their second or third toes could be longer and need more space. 


Your genetics may also predispose you to hammertoes. Other contributing factors include previous injuries and pressure from a bunion or other foot deformity. 


Signs & symptoms


Aside from the obvious change in the shape of the toes, your toes may become red, swollen, stiff and painful. Many people also develop corns, calluses or blisters on the tops where the joints rub against the shoes. This can make it uncomfortable and painful to walk or wear certain types of shoes.


Treating hammertoes


When the changes to the joints are caught early, it’s the easiest to get the best results using conservative (non-invasive or surgical) treatments. The longer the toes are left untreated, and the more rigid they are, the more difficult they can be to treat. Your care with us may include:


  • Changes to your regular footwear to ensure it’s not making the problem progress at a fast rate
  • Using strapping and splinting to help keep the toes in a better position and encourage them to straighten
  • Manual therapy on the tendons and muscles themselves to help them loosen, including stretching and strengthening of the toes
  • Custom foot orthotics or forefoot padding to support the healthy function and position of your feet 


While we always try to correct your problem with conservative measures first, in advanced cases, this may not be possible. If your hammertoes are causing you pain and making it difficult for you to walk or wear footwear, you may be referred to an orthopaedic surgeon to correct the problem surgically. It’s important to consider the risks of any surgical procedure and ensure that the benefits outweigh the risks.