Hammertoe (or Claw): What Causes It and What to Do About It?

Do you have a toe that bends back on its own, rubs in your shoes or hurts when you walk? You may have a hammertoe (also known as a claw toe).

This is a common deformity.

In this article, I explain to you as a physiotherapist how to recognize a hammertoe, what causes it, and above all what you can do to improve it or relieve the pain.

♻️ Last update: July 27, 2025.
👩‍⚖️ Declaration of financial interests: none directly related to the subject. My complete declaration of financial interests is available in the legal notice section.
Written by Nelly Darbois, physiotherapist and scientific editor

How can you be sure it’s a hammer toe?

Have you noticed that one of your toes is starting to bend downwards, as if forming a little hook? It could be a hammertoe.

Concretely, it’s a deformity in which the toe remains bent at the middle joint (the joint between the 1st and 2nd phalanges). It most often affects the 2nd or 3rd toe.

The toe may remain flexible at first, then become rigid over time.

This is different from :

❌ the claw toe, where the toe is also bent at the tip (last phalanx), and sometimes even raised at the base ;

❌ the inverted hammer toe (rarer), which starts upwards.

Common symptoms of hammertoe are :

• pain when walking or wearing closed shoes;
• rubbing or corns on the top of the toe;
• aesthetic discomfort ;
• difficulty putting foot down correctly.

Diagnosis is mainly clinical: your doctor, physiotherapist or podiatrist looks at the shape of the toe, its flexibility and your overall posture. In some (rare) cases, an X-ray may be useful to rule out another cause, which would require a specific and different treatment.

No need for dozens of examinations: a visual examination and a few mobility tests are often enough to confirm the diagnosis.

What are the most common causes of hammertoes?

In the vast majority of cases, hammertoes are caused by several factors, but none of them can be identified with certainty.

👉 Genetic predisposition: some people are more at risk of developing this malformation no matter what they do.

👉 Ill-fitting shoes: toes too narrow, heels too high, lack of room for the toes. This forces the toe to fold back… and it ends up staying that way.

👉 Age: tissues lose suppleness, joints wear out, and certain deformities appear more easily over time.

👉 Muscle imbalance: some muscles pull too hard on the toe, while others no longer compensate.

👉 Neurological causes: rarer. Nerve damage (e.g. diabetes, multiple sclerosis) can disrupt muscle control, leading to progressive deformities.

👉 O ther chronic illnesses: inflammatory diseases such as polyarthritis, diabetes.

It’s common to have a hallux valgus problem in addition to a hammertoe problem.

Can hammertoes be straightened with exercise?

Opinions are divided on this point. Some professionals believe that exercises can permanently straighten the toes, while others are more reserved.

The stage of the deformity, your age, your joint mobility and your regularity also come into play.

Here’s a summary of the arguments for and against exercises to straighten hammertoes.

✅ Arguments in favor of their effectiveness	❌ Arguments against their effectiveness
Exercises strengthen foot muscles and maintain mobility	Bone deformities and loss of soft-tissue extensibility (ligaments, etc.) are not easily reducible.
It’s easy to set up from home, and requires no special equipment.	Requires regularity and motivation over the long term, as potential effects disappear if you stop
Low risk of side effects (apart from possible temporary pain)

Are splints useful for straightening a hammertoe?

Opinions on splints also differ.

✅ Arguments in favor of their effectiveness	❌ Arguments against their effectiveness
They keep the toe in a more elongated position, limiting aggravation.	They do not correct rigid or old deformities.
Effective in limiting aggravation, especially in flexible, recent forms.	Some splints are uncomfortable or awkward in shoes.
Relieves friction pain (especially in shoes).	Poorly chosen or badly adapted, they can cause irritation or pain.

There are at least 3 different types of splint (also known as orthosis) for hammertoes.

• Rigid night splints: gently hold the toe in extension during sleep.
• Soft orthotics or daytime silicone orthotics: more discreet, these are used in shoes to limit conflicts and slightly reposition the toe.
• Custom-madeorthoplastics: made by a podiatrist, they are often more comfortable and better adapted to your foot.

All are available without prescription, and can be purchased over the Internet or from a podiatrist. For custom-made splints, a doctor’s prescription may be required to obtain reimbursement from the French health insurance system.

Which shoes to wear?

With a hammertoe, the choice of footwear is essential to avoid pain and limit aggravation.

✅ Prefer shoes.

• Wide enough at the front to avoid compressing the toes.
• With a supple upper (leather or stretch fabric) that leaves room for the curved toe.
• No significantheel.

❌ Avoid as much as possible:

• Pointed or narrow tips.
• High heels.
• Stiff shoes, with no flexibility in the toes.

👉 Ideally, you should try on your shoes at the end of the day (when your feet are a little swollen), with any orthotics you may have. You should feel comfortable in them from the very first step.

What about hammertoe surgery?

In general, surgery is recommended if the pain becomes too severe, or if the toe has stiffened to the point of impeding walking, despite appropriate footwear, exercises or orthoses (conservative treatment).

Non-hallux toe surgery accounts for 48% of forefoot procedures, with claw toe surgery being the most common (Goransson 2023).

Several techniques are available:

• section of a tendon,
• arthrodesis,
• arthroplasty,
• osteotomy,
• broach fitting, etc.

The choice depends on the type of deformity and your general condition. The procedure is often performed on an outpatient basis, under local or locoregional anesthesia.

But beware: like any operation, it carries risks (persistent pain, stiffness, swelling, recurrence…). Recovery can take several weeks, sometimes requiring a visit to a post-operative physiotherapist.

A Mexican-Spanish research team (de Jesús Mayagoitia-Vázquez 2024) compiled all relevant studies on hammertoe surgery in 2024. Here’s an extract from their conclusion:

After reviewing 16 articles, we found that claw deformity remains a problem for patients, even after surgical treatment, confirming our hypothesis.

The recurrence rates described are 1 in 10 cases after surgery, and recurrence is more frequent if:

• the second toe is operated on (rather than the 3rd or fourth)
• whether the deformity is transverse (to the left or right) rather than sagittal (downward, bent).

In general, after the operation you will have a walking boot for 2 to 6 weeks to avoid putting too much pressure on the toe when walking.

The most frequent surgical complications include :

• infection,
• non-consolidation of bone,
• hematoma,
• numbness.

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That’s all I wanted to say on the subject! Any questions or comments? See you in comments!