When it comes to hammertoe causes, the most common one is an imbalance in the muscles and tendons that control your toes — often set off by shoes that are too tight or too narrow, especially high heels and pointed toe boxes that force your toes to bend and stay bent. Over time, that bent position can become stiff and painful. Other contributors include foot structure, arthritis, and nerve problems, but ill-fitting footwear is the trigger most people can actually do something about. Caught early, a flexible hammertoe often improves with better shoes and stretching.
See a doctor promptly if you notice any of these:
- A toe that is stuck bent and will not straighten, even with your hands
- Severe pain, swelling, redness, or an open sore on top of or between the toes
- A sore or wound on your foot that will not heal, especially if you have diabetes
- Numbness, tingling, or weakness in your feet alongside the toe change
- Pain that keeps you from walking comfortably despite better shoes
What a hammertoe is and why it develops
A hammertoe is a toe — usually the second, third, or fourth toe — that bends abnormally at the middle joint, so it curls downward like a hammer or claw. At first the toe is still flexible: you can straighten it with your fingers, and it may only ache after a long day in tight shoes. Left alone, the tendons and joints can tighten until the toe becomes rigid and stays bent, making walking and fitting shoes harder.
The root cause is usually a muscle imbalance. The muscles that bend your toes and the ones that straighten them are supposed to work as a team. When one side overpowers the other — because of your foot shape, nerve damage, arthritis, or years of wearing shoes that cramp your toes — the toe gets pulled into that bent position and held there. High heels are a classic trigger, because they push your foot forward and jam your toes into the narrow front of the shoe. Shoes that are simply too short do the same thing, even without a heel.
Foot structure plays a role too. A long second toe, flat feet, or high arches can put your toes under extra pressure, and tight shoes tip the balance further. Arthritis can damage the toe joints, nerve conditions including diabetes can weaken the small foot muscles, and a toe injury or bunion can shift pressure onto neighbouring toes.
A mallet toe bends at the joint nearest the tip rather than the middle joint, and a claw toe bends at both joints. The causes overlap, but a clinician can tell them apart, and treatment depends on which joints are involved.
What helps a hammertoe
If your hammertoe is still flexible, footwear is the first and most powerful fix. Switch to shoes with a wide, deep toe box that lets your toes lie flat, and keep heels low. That alone often stops the pain worsening, because it removes the force holding the toe bent. According to the Mayo Clinic, roomy, comfortable shoes and avoiding high heels are the first step in managing hammertoe, and many people find their symptoms ease noticeably once they make that change.
Padding and gentle stretching help alongside better shoes. A corn pad over the bent joint protects it from rubbing, and toe separators worn at home can encourage the toe to rest straighter. Stretch the toe gently with your hands several times a day, and pick up a towel with your toes to strengthen the muscles that keep them straight.
Over-the-counter pain relief and ice can calm a sore joint after a long day, but they do not fix the bend itself. If corns build up on the bent toe, a podiatrist can trim them safely; do not cut them yourself, especially if you have diabetes. For a rigid hammertoe, or one that hurts daily despite good shoes, a clinician may suggest orthotics, physical therapy, or surgery. The Cleveland Clinic notes surgery is usually reserved for rigid toes that do not respond to conservative care.
Timing matters: a flexible hammertoe gives you options, while a rigid one narrows them. If you notice a toe starting to curl, change the shoes, stretch the toe, and get it looked at if it does not improve.
A daily routine for a hammertoe
Start the morning by checking your toes — a quick look for redness or new corns takes seconds and catches skin breakdown early, which matters a lot if you have diabetes. Wash your feet with warm water and mild soap, dry them well between the toes, and put on clean socks that are not tight around the toes.
Choose shoes with a wide, deep toe box every day, and add a small pad over the bent joint if it rubs. Slip your shoes off when you can and gently stretch the toe straight a few times. In the evening, spend five minutes on toe exercises — towel scrunches and gentle manual stretches.
Once a week, take an honest look at your shoes. Worn-out toe boxes and pairs that pinch your toes are working against you, however much you like them.
Frequently asked questions
Can a hammertoe straighten out on its own?
A flexible hammertoe can improve with better shoes and stretching, because the joint has not stiffened yet. A rigid hammertoe, where the toe will not straighten even with your hands, will not correct itself and usually needs a clinician to assess treatment options.
Are high heels really a cause of hammertoe?
Yes — high heels are one of the most common contributors. They force your foot forward into a narrow toe box, which bends the toes and holds them bent for hours. Over time that repeated pressure can create the muscle imbalance that leads to a hammertoe, especially combined with a foot shape that already puts extra load on the toes.
Is hammertoe the same as a bunion?
No, although they often appear together. A bunion is a bony bump at the base of the big toe where the big toe angles inward, while a hammertoe is a bending deformity of a smaller toe. A bunion can crowd the neighbouring toes and contribute to a hammertoe, which is why both are often linked to tight, narrow shoes.
When does a hammertoe need surgery?
Surgery is usually considered when the toe is rigid, painful daily, or causing sores despite roomy shoes, padding, and orthotics. A surgeon will assess joint stiffness and tendons first, and most people try conservative care first.
Can children get hammertoes?
A true hammertoe in a child is less common and more likely linked to a muscle or nerve condition, or shoes that are far too small. If a child’s toe is curling or stiff, have a clinician check it rather than assuming they will grow out of it.
Sources
- Mayo Clinic — Hammertoe and mallet toe: causes and treatment
- Cleveland Clinic — Hammertoe: symptoms, causes, and treatment options
- American Academy of Orthopaedic Surgeons — Toe deformities and footwear guidance
This article is for information only and is not medical advice. If your toe is rigid, painful, or developing sores, or if you have diabetes, talk to a healthcare professional.