Hammertoes
A hammertoe is a bend or curl in one of your smaller toes that, left unaddressed, tends to stiffen over time and become harder to correct without surgery.
At Emerald Hill Podiatry, we assess whether your hammertoe is still flexible or has become fixed, then build a plan around what stage you’re at, aiming to ease discomfort and, where possible, keep surgery off the table.
What Are Hammertoes
A hammertoe is a deformity in which one of the smaller toes, most commonly the second toe, bends abnormally at the middle joint, creating a claw-like or hammer-like appearance. It develops when the tendons controlling the toe fall out of balance, pulling the joint into a bent position that it can no longer straighten out of on its own.
Hammertoes typically start out mild and worsen gradually, progressing from a flexible, correctable bend to a fixed one, at which point conservative management becomes far more limited. Related deformities, such as claw toe and mallet toe, involve similar tendon imbalances at slightly different joints and are managed using the same general approach.
Flexible vs Fixed Hammertoes
- Flexible hammertoes — the toe can still be manually straightened, and usually responds well to conservative measures like padding, splinting, and footwear changes
- Fixed (rigid) hammertoes — the joint has stiffened to the point where it can no longer be straightened; treatment shifts to managing pain and pressure, and surgery becomes the only option for a structural fix
Because hammertoes tend to move from flexible to fixed over time, catching the deformity early generally means more treatment options and a better chance of avoiding surgery.
How Muscle Imbalance Creates the Deformity
Common contributors to this imbalance include:
- Footwear that crowds the toes, such as narrow shoes or high heels
- Foot structure, including a long second toe or an existing bunion crowding adjacent toes
- Muscle and tendon imbalances, sometimes linked to underlying nerve or muscular conditions
- Trauma from a previous toe injury
- Age-related changes in tendon and ligament tension
When to See a Podiatrist
You should see a podiatrist if:
A toe beginning to bend or curl and staying that way
The affected toe is still flexible, the stage where conservative treatment is most effective
Pain, redness, or a corn/callus forming over the bent joint
The toe has become stiff and no longer straightens, even with gentle pressure
Finding comfortable, well-fitting footwear has become difficult
Since hammertoes tend to stiffen progressively, earlier assessment gives you the best chance of managing the deformity without surgery.
Get Your Hammertoe Properly Assessed
Our Approach to Hammertoes
Treatment depends heavily on whether the toe is still flexible or has become fixed, this distinction shapes everything from which conservative measures apply to whether surgery needs consideration.
Options include:
- Custom Orthotics — corrects the underlying foot mechanics contributing to the muscle imbalance, easing strain on the affected toe and slowing further progression
- Toe Splints and Padding — holds a flexible toe in a straighter position and cushions the joint against footwear, most effective when started early
- Biomechanical Gait Assessment — identifies the mechanical patterns contributing to the deformity, informing footwear, orthotic design, and activity adjustments
- Surgical Referral for Rigid Cases — for fixed, painful, or functionally limiting hammertoes, we discuss suitability and refer you to a trusted orthopaedic surgeon
What to Expect at Your Assessment
Your podiatrist reviews when the deformity started, your footwear history, and pain levels, then examines whether the toe is still flexible or fixed, checking for corns, calluses, and gait patterns contributing to the imbalance. X-rays may be used if surgery is being considered. From there, you’ll be walked through realistic treatment goals, with periodic reassessment since hammertoes can progress from flexible to fixed over time.
