A hammer toe or claw toe that can still be straightened by hand usually does well with roomier shoes, padding and toe exercises. Once the toe is RIGID and painful, surgery is the reliable fix.
The first thing to check is simple. Gently push the bent toe straight with your finger. If it straightens, it’s flexible, and now is the time to act, because many bent toes stiffen over time if nothing changes.
Treatment won’t straighten a toe that has already set. It can take away the rubbing and the pain, which is what most people want.
Hammer toe or claw toe?
- Hammer toe: the toe bends down at the middle joint, so the knuckle sticks up. It most often affects the second, third or fourth toe, and the second toe most of all
- Claw toe: the toe bends down at both the middle and end joints, while the joint where the toe meets the foot bends up. The toe curls like a claw, and it often affects several toes at once
- Mallet toe: only the joint nearest the nail bends down
All three cause the same problems: a knuckle that rubs on the top of the shoe, a tip that presses into the ground, and painful corns or calluses where they rub. Claw toes also push the ball of the foot down, which can cause pain there.
See metatarsalgia.
What causes them
- Shoes: tight, narrow or short shoes and high heels crowd the toes so they can’t lie flat. Over years the tendons and joints tighten in that bent position
- Muscle imbalance: the small muscles that hold the toes straight lose out to the stronger tendons that curl them
- A bunion: as the big toe drifts over, it crowds the second toe, which often buckles into a hammer toe. See bunion surgery recovery
- Foot shape: a second toe longer than the big toe, a high arch or a flat foot all change how the toes take load
- Nerve problems: claw toes in particular can come from nerve damage, such as from diabetes or heavy alcohol use, a stroke, or an inherited nerve condition called Charcot-Marie-Tooth disease
- Arthritis: rheumatoid arthritis and osteoarthritis can damage the toe joints and pull them out of line
- Injury: a stubbed, jammed or broken toe can heal bent
If several toes on BOTH feet have clawed without an obvious reason, mention it to your doctor. A nerve problem can be behind it, and that’s worth looking for.
Flexible or rigid
- Flexible: the toe straightens when you push it or when you stand with weight on it. Shoes, pads and exercises have the most to offer here
- Rigid: the joint is stuck and won’t straighten. Padding and roomier shoes can still ease the rubbing, but only surgery changes the shape
What helps
- Room for the toes: a soft, deep, wide toe box, about half an inch longer than your longest toe, with a low heel. Shop late in the day when feet are at their biggest
- Check the depth, not only the width: the raised knuckle needs space above it. A shoe that fits the foot but presses on the top of the toe will keep the corn coming back
- Non-medicated pads: foam or gel toe sleeves, cushions and corn pads protect the knuckle and the tip of the toe. Toe straps or crest pads that sit under the toes can help a flexible toe lie flatter
- Insoles: arch supports or a pad under the ball of the foot can ease pressure there if you have claw toes
- Toe exercises: towel scrunches, where you pull a towel toward you with your toes, and picking up small objects with your toes. They strengthen the small muscles that help hold the toes straight
- Stretch by hand: gently ease the bent toe straight and hold it there for a little while, a few times a day, to keep a flexible toe flexible
If you have diabetes or poor circulation, don’t treat corns yourself, cut them, or use medicated corn plasters. Have a podiatrist, a foot specialist, look after them.
A flexible toe needs room. A rigid, painful toe needs a surgeon.
When surgery makes sense
Surgery is worth discussing when the toe is painful, the rubbing keeps causing corns or sores, and roomier shoes and padding haven’t helped.
- For a flexible toe: releasing or moving a tendon can rebalance the toe without touching the bone
- For a rigid toe: the surgeon removes a small piece of bone at the stuck joint and lets the toe heal straight, often held with a thin wire or small implant while the bone joins
- Straight but stiffer: a fused toe no longer bends at that joint. That’s the aim of the operation, not a sign it failed
- Getting about: you can usually walk straight away in a special flat post-op shoe. If a wire is used, it comes out at about 4 to 6 weeks
- Swelling: the toe often stays swollen for months. Full recovery commonly takes about six months, and occasionally up to a year
- Results: most people are satisfied with how the toe feels and fits in shoes afterward, but some stiffness or ongoing discomfort is possible
The American Academy of Orthopaedic Surgeons has a helpful guide to hammer toe treatment and surgery.
Get seen today if
- You have diabetes and find an open sore, blister, or dark or bleeding patch on a toe
- A toe is red, hot and swollen, there’s pus, or you have a fever
- A toe turns pale, blue, black or cold
Get it checked if
- A toe is getting stiffer or bending more over the months
- Corns keep coming back despite better shoes and padding
- Several toes are clawing, especially on both feet, or you have numbness or tingling in your feet
- The second toe is starting to drift or lift, with pain under its base. Catching this early matters
- Foot pain is affecting how far you can walk
Catch a bent toe while it still straightens, and shoes and pads can do most of the work.