A hammer toe is a physical deformity of the foot in which a toe or toes, instead of pointing forward, are bent or curled downward. Hammer toe may appear in any toe but most commonly occurs in the second, third or fourth toes.

Hammer toe is ultimately caused by an imbalance of the muscles in the foot leading to the toes being pulled in unnatural directions. Underlying causes that can result in hammer toes are:

● Injury to the toes or foot
● Rheumatoid arthritis which is an autoimmune condition that affects joint and can cause deformity
● Ill-fitting shoes causing muscular imbalances to be applied to the foot.
● Tight ligaments or tendons causing the toes to be pulled in unnatural directions
● Pressure from a bunion
● Genetics may play a role; you may have inherited a predisposition for this condition to develop later in life

Symptoms of a hammer toe are easy to identify visually, as a physical deformity of the toes will be present. The affected toe or toes will be bent and misshapen, resembling a hammer. Other symptoms that may be present with this condition are:

● Significant pain in the affected toe or toes
● Frequent corns or calluses forming on the top of the toes
● Loss of range of motion of the toes, especially an inability to fully extend (straighten) the toes
● Swelling and erythema (reddening of the skin)
● An open sore may develop in more advanced cases

Hammer toe needs to be treated immediately. At first, when this deformity begins to present itself, the ligaments are still malleable and can be easily stretched. Over time and without proper treatment, this deformity may become fixed and surgical intervention may be necessary in order to correct the deformity. Also, untreated hammer toe may cause open sores to develop on top of the foot which puts you at great risk for infection.

But before surgery is necessary, a course of physical therapy has the possibility of effectively treating this condition. Proper strengthening exercises as well as flexibility exercises will be utilized in physical therapy in order to decrease some of the muscular imbalances in the foot. There are modalities that can be used in physical therapy in order to decrease pain and swelling. Some exercises that you can do on your own to keep the foot strong and flexible and lessen the risk of developing hammer toe are:

● Calf stretch, Great toe extension stretch, plantar fascia stretches
● Picking up marbles with your toes or placing a towel underneath your feet and rolling it towards you using your toes

In an attempt to avoid surgery, things you can try:

● Wear comfortable, roomy shoes
● A custom orthotic or over the counter arch supports for your shoes
● Corn and callus pads to cover any sores, open or closed
● Cortisone injection to help with pain


If the condition has progressed to a point that surgery is indicated, there are different surgical options that you and your doctor may choose from. These include a tendon transfer, an arthroplasty (joint replacement), a phalangectomy (removal of bone), or an osteotomy (reshaping of bone).