A hammer toe is a deformity that causes your toe to bend or curl downward instead of pointing forward. This deformity can affect any toe on your foot. It most often affects the second or third toe. Although a hammer toe may be present at birth, it usually develops over time due to arthritis or wearing ill-fitting shoes, such as tight, pointed heels. In most cases, a hammer toe condition is treatable.
Initially, hammer toes are flexible and can be corrected with simple measures but, if left untreated, they can become fixed and require surgery.
People with hammer toe may have corns or calluses on the top of the middle joint of the toe or on the tip of the toe. They may also feel pain in their toes or feet and have difficulty finding comfortable shoes.
Common causes of hammer toe include: a traumatic toe injury, arthritis, an unusually high foot arch, wearing shoes that don’t fit properly, tightened ligaments or tendons in the foot, pressure from a bunion, which is when your big toe points inward toward your second toe.
Hammer toe results from shoes that don't fit properly or a muscle imbalance, usually in combination with one or more other factors. Muscles work in pairs to straighten and bend the toes. If the toe is bent and held in one position long enough, the muscles tighten and cannot stretch out.
Shoes that narrow toward the toe may make your forefoot look smaller. But they also push the smaller toes into a flexed (bent) position. The toes rub against the shoe, leading to the formation of corns and calluses, which further aggravate the condition. A higher heel forces the foot down and squishes the toes against the shoe, increasing the pressure and the bend in the toe. Eventually, the toe muscles become unable to straighten the toe, even when there is no confining shoe.
Conservative treatment starts with new shoes that have soft, roomy toe boxes. Shoes should be one-half inch longer than your longest toe. (Note: For many people, the second toe is longer than the big toe.) Avoid wearing tight, narrow, high-heeled shoes. You may also be able to find a shoe with a deep toe box that accommodates the hammer toe. Sandals may help, as long as they do not pinch or rub other areas of the foot.
Cushions or gel toe crests may also relieve symptoms and help hold your toes in their natural positions.
A podiatrist or physiotherapist may also prescribe some toe exercises that you can do at home to stretch and strengthen the muscles. For example, you can gently stretch the toes manually. You can use your toes to pick things up off the floor. While you watch television or read, you can put a towel flat under your feet and use your toes to crumple it. A podiatrist may also prescribe strapping or some other form of corrective solution.