FOOT CONDITION GUIDE
Hammer Toe Explained
Hammer toe is a common foot condition where one or more of the smaller toes bend at the middle joint instead of lying flat. It can lead to pain, pressure, shoe discomfort, and difficulty with movement. This guide explains what hammer toe is, why it happens, and what you can do to improve foot function.
Hammer toe most commonly affects the second toe, although it can occur in the other lesser toes as well. The deformity happens when the toe bends downward at the middle joint, creating a curled position rather than resting flat. Research suggests hammer toe affects around 6–7% of the general population and may be present in up to 2 in 5 people with foot or ankle discomfort.
Quick fact
Hammer toe is one of the most common lesser toe deformities and can range from flexible and mild to rigid and painful.
Kim et al. (2024). Schrier et al. (2009).
What is hammer toe?
Hammer toe is a deformity where one or more of the smaller toes bend at the middle joint, causing them to curl downward rather than lie flat. It often develops gradually and may start as a flexible toe that can still be straightened, but over time it can become stiffer and more rigid.
Definition
What it looks like
One or more lesser toes bend at the middle joint and sit in a curled position instead of resting flat on the ground.
Most common
Usually affects the second toe
Hammer toe most often involves the second toe, though it can also affect the third, fourth, or fifth toes.
Types
Flexible, semi-rigid, or rigid
Early stage hammer toes are often flexible. As the condition progresses, the joint may become stiffer and harder to correct.
Why it matters
Can affect comfort and movement
Hammer toe can create pain, corns, calluses, pressure in shoes, and difficulty with walking, balance, and activity.
Hammer toe is not just a cosmetic issue. It can change how the foot loads, how you walk, and how comfortable everyday movement feels.
What causes hammer toe?
Hammer toe is usually caused by a combination of factors rather than one single issue. Muscle imbalances between the muscles that bend and straighten the toes can contribute, especially when combined with weakness in the small intrinsic foot muscles. Other contributing factors can include bunions, trauma, reduced ankle or foot mobility, altered foot mechanics, diabetes, peripheral neuropathy, and age-related changes.
- Muscle imbalance between toe flexors and extensors
- Weak intrinsic foot muscles
- Hallux valgus or bunions
- Foot or toe trauma
- Reduced ankle or foot mobility
- Tight or narrow footwear, including high heels
- Ageing, diabetes, or peripheral neuropathy
Signs and symptoms
The clearest sign of hammer toe is one or more lesser toes bending at the middle joint. Many people also notice pain in and out of shoes, pressure on the top of the toe, reduced toe mobility, and discomfort through the forefoot. Corns and calluses can develop over the bent joint or under the ball of the foot due to increased pressure.
- One or more toes curling downward
- Pain while walking or standing
- Discomfort in shoes
- Corns or calluses
- Reduced toe mobility
- Difficulty finding comfortable footwear
How hammer toe can affect movement and lifestyle
Hammer toe can have a real impact on daily life. It may change the way you walk as your body tries to reduce pressure on the painful area. Research suggests hammer toe can reduce overall foot function and affect how the foot absorbs and releases energy during walking and movement. Ongoing discomfort may also limit exercise, work demands, social activities, and confidence in being active.
In older adults, lesser toe deformities such as hammer toe have also been linked with a higher risk of falls.
Conventional treatment options
Treatment depends on how severe the hammer toe is and whether it is still flexible. Non-surgical treatment is usually the first option for most people. This can include footwear changes, exercises, stretching, strengthening work, and physical therapy.
Shoes with a wide toe box are often recommended to reduce pressure on the toes, while tight-fitting shoes and high heels are best avoided. For more severe or persistent cases, surgery may be considered. A common surgical option is proximal interphalangeal joint correction, which aims to straighten the toe by correcting the bent middle joint.
Prevention and self-care
Prevention focuses on reducing pressure on the toes and improving foot function. Wearing shoes with enough space for the toes to spread naturally is an important first step. Foot strength and mobility exercises may also help improve foot control, strength, and movement quality.
- Choose shoes with a wide toe box to reduce compression on the toes
- Avoid narrow shoes and high heels where possible
- Build foot strength with regular foot-specific exercises
- Improve mobility through the toes, foot, and ankle
- Use toe spacers where appropriate to support toe alignment and reduce pressure
Hammer Toe Condition Program
Restore comfort and natural movement with this 8-week program designed to ease hammer toe discomfort and improve toe alignment. With three guided sessions each week, you’ll focus on strengthening, mobilisation, balance, and release work to support healthier, more functional feet. Using simple tools like toe spacers, toe band, mini ball, mini roller, and bean bag, you’ll activate key muscles, reduce tension, and promote lasting foot health and mobility.
Course Length
8 weeks
A focused 8-week program to improve toe alignment and foot function through consistent, guided sessions.
Equipment
Mini roller, mini ball, toe spacers, toe band, and bean bag.
Utilise simple tools designed to activate muscles, increase mobility, and support effective foot care.
Targeting
Strengthening, balancing, mobilisation, and release work
Each session combines targeted exercises to reduce tension, enhance balance, and restore natural foot mechanics.
Recommended Rehab Mechanics tools
Tools can be helpful when paired with a clear exercise plan. These kits are designed to support strength, mobility, proprioception, and foot function.
References
Schrier, J. C. M., Verheyen, C. C. P. M., & Louwerens, J. W. (2009). Definitions of Hammer Toe and Claw Toe: An Evaluation of the Literature. Journal of the American Podiatric Medical Association, 99(3), 194-197.
Kwon, O. Y., Tuttle, L. J., Johnson, J. E., & Mueller, M. J. (2009). Muscle imbalance and reduced ankle joint motion in people with hammer toe deformity. Clinical Biomechanics, 24(8), 670-675.
Kim, K. C., Schmidt, E., de Carvalho, K. A. M., Lalevee, M., Mansur, N., Dibbern, K., Auch, E., Behrens, A., & Netto, C. D. C. (2024). Prevalence of midfoot arthritis and lesser toe deformities. Foot and Ankle Surgery, 30(5), 423-431.
Schuberth, J. M. (1999). Hammer toe syndrome. The Journal of Foot and Ankle Surgery, 38(2), 166-178.
Moayedi, M., Arshi, A. R., Salehi, M., Akrami, M., Javadi Asl, N., & Naemi, R. (2023). An investigation into the hammer toe effects on the lower extremity mechanics and plantar fascia tension: A case for a vicious cycle and progressive damage. Computers in Biology and Medicine, 152, 106381.
Ellington, J. K. (2011). Hammertoes and Clawtoes: Proximal Interphalangeal Joint Correction. Foot and Ankle Clinics, 16(4), 547-558.
Darcel, V., & Piclet-Legré, B. (2023). Lesser-toe deformity. Orthopaedics & Traumatology: Surgery & Research, 109(1, Supplement), 103464.
Curtis, R., Willems, C., Paoletti, P., & D'Août, K. (2021). Daily activity in minimal footwear increases foot strength. Scientific Reports, 11(1), 18648.
Ahmed, M., Zaki, S., Alam, M. F., Sharma, S., Al Salman, A. A., Altaweel, A., Alkhadrawi, N., Nuhmani, S., & Khan, H. (2024). The impact of intrinsic foot muscle strengthening exercises in asymptomatic athletes with normal foot structure: A systematic review. Clinical Epidemiology and Global Health, 27, 101597.
Formosa, C., Grixti, C., & Gatt, A. (2022). Conservative Approach in the Management of Lesser Toe Deformities in Older Adults. Journal of the American Podiatric Medical Association, 112(3), 20-274.