If your toes have become bent over time and your shoes rub the tops of your toes, you may have a condition called hammertoe.

“Hammertoe is a condition where the tendons in the toes pull the toes into a bent position,” says Jocelyn Curry, DPM, a Piedmont podiatrist.

Hammertoe is a deformity that affects the middle joint in the second, third, fourth or fifth toes.

What causes a hammertoe?

“Hammertoe can be a genetic condition and tends to be more common in people with high foot arches or flat arches,” Dr. Curry says. “Wearing shoes like flip-flops and slides can cause the toes to grip the shoes to keep them in place. Continuing to wear these shoes can make hammertoes worse.”

Instead, she recommends wearing supportive shoes that fit securely on your foot.

“If you swing your foot in the air and your shoe flies off, that isn’t a shoe you want to wear on a daily basis,” she says. “The constant grip of the small muscles in the toes can weaken the muscles and lead to the hammertoe deformity over time.”

Hammertoe symptoms

The most common complaint Dr. Curry hears from patients is pain on the toe's top or tip (end). 

“When the toes are curved, they can rub on the top of your shoes, leading to corns,” she says. “A corn is a hardened layer of skin over a bony area on the foot. People with hammertoe often see discoloration on the tops of the toes.”

If you develop a corn, avoid picking at the hardened skin and don’t use an over-the-counter corn remover, which can damage healthy tissue.

“Hammertoe can also create retrograde pressure on the bone behind the toes, leading to a callus across the ball of the foot,” Dr. Curry says. “It can also lead to lesions on other places of the foot.”

She says it’s a good idea to get evaluated by a podiatrist if you notice discoloration on the tops of your toes or have toe pain.

Can hammertoes be prevented?

“Hammertoes can sometimes be prevented if it’s caught early enough,” says Dr. Curry. “If we can change how the foot hits the ground or address a flat arch, that can help. Certain shoes and arch supports can reduce the pull of the tendons in the toes. This can decrease the chances of the condition becoming painful and needing surgery.”

How is a hammertoe treated? 

She says a hammertoe is generally classified into two categories:

• Flexible hammertoe: If you can pull your toe into a straightened position with your fingers, this is considered a flexible hammertoe. Flexible hammertoe isn’t usually a major concern, though you should see a podiatrist to learn how to keep the condition from worsening.

• Rigid hammertoe: If you can’t pull your toe into a straightened position with your fingers, you likely have a rigid hammertoe, which may require surgery.

Dr. Curry says nonsurgical hammertoe treatment options include:

• Wearing shoes with a wide toe box and good arch support. If you work from home, wearing supportive shoes around the house is important, rather than going barefoot or wearing flip-flops.   

• Not wearing flip-flops, slides or pointed-toe shoes on a daily basis.

• Wearing silicone pads to protect corns on the tops of the toes.

If the toes are rigid, or you have diabetes and are at higher risk for a bone infection, your podiatrist may recommend surgery to correct the deformity.

“If you have diabetes, you’re at higher risk for foot sores and infection,” she says. “You may also have peripheral neuropathy or reduced sensation in your feet. If you have diabetes, it’s important to see a podiatrist to form a plan to ensure your feet stay healthy, particularly if you have a hammertoe.”

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