Hammer Toe: causes, symptoms & treaments

Dr. Baravarian talks about the causes of a hammer toes and, most importantly, the ways to correct them.

A hammer toe is a toe that is bent because of a muscle imbalance around the toe joints. The imbalance causes the toe to bend at one or more joints, pushing the middle of the toe upward in a claw-like position.


If you notice such changes, it is important to seek proper treatment. Hammer toes never get better without some type of intervention and the sooner it is treated, the better the outcome.

The University Foot and Ankle Institute have revolutionized the approach to hammer toe correction. We have decades of combined experience and pride ourselves in offering the most advanced diagnostic technology and treatment options available in the most relaxed and comfortable environment.

What causes a Hammer Toe?

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Though hammer toes are principally hereditary, several other factors can contribute to the deformity. Most prevalent is an imbalance of the muscles and tendons that control the motion of the toe. When the tendon that pulls the toe upward is not as strong as the one that pulls it downward there is a disparity of power. This forces the toe to buckle and gradually become deformed. If the it persists, the toe can become rigid and harder to correct.


Patients who have a high-arched feet have an increased chance of hammer toes occurring. Also, patients with bunion deformities notice the second toe elevating and becoming hammered to make room for the big toe that is moving toward it.


Some patients damage the ligament that holds the toe in place at the bottom of the joint that connects the toe and foot. When this ligament (plantar plate) is disrupted or torn, the toe floats upward at this joint.


Hammer toes also occur in women wearing ill-fitting shoes or high heels, and children wearing shoes they have outgrown.


Hammer Toe symptoms

Hammer toes can cause problems with walking and lead to other foot problems, such as blisters, calluses, and sores. Pain is caused by constant friction over the top of the toe’s main joint.


It may be difficult to fit into some shoe gear due to the extra space required for the deformed toe. In many cases there will be pain on the ball of the foot over the metatarsals along with callus formation. This is due to the toes not functioning properly, failing to properly touch the ground during the gait cycle. The ball of the foot then takes the brunt of the ground forces, which causes chronic pain.


How is Hammer Toe diagnosed?

Clinical observation of the toe is made to assess what part of the toe is involved in the deformity. We will also determine if the hammer toe is flexible (able to be reduced) or rigid. Plain x-rays also determine the extent of the contracture. An examination of the entire foot identifies the root cause of the deformity.


Non-Invasive Hammer Toe treatments

Conservative treatment is limited to accommodation, not correction, of the deformity, though some patients find the relief they can get from these options to be more than enough to put off or even avoid surgery.  These include:


Better Footwear

Shoe gear with a wider toe box and higher volume causes less friction to the toes.


Toe Braces and Strapping

Some toe braces and strapping techniques take some pressure off the toes during gait.


Custom Orthotics

Custom molded orthotics can redistribute the forces through the tendons that control the toe, lessening the pain and extent of the deformity.


Callus Control

The calluses on the toe and the ball of the foot can be shaved occasionally to reduce some pain and pressure, although they will return due to the constant deformity.


Surgical Correction Options for Hammer Toe

Hammertoe Representation

Surgical correction is needed to bring the toe into a corrected position and increase its function. Correction of the hammer toes is a simple outpatient surgery, with limited downtime.


Fusing the toe into a straight position

The best option is to fuse the deformed and contracted toe into a straight position. This limits the need for future surgery and deformity return. A new pin that absorbs in the bone or small screw is used by the Foot and Ankle Institute to avoid the need for a metal pin protruding from the toe during recovery. Although the absorbable pin is not for everyone, it is much more comfortable than the pin protruding from the end of the toe.


Removing the Hammer Toe deformity

In certain cases, a removal of a small area of bone in the deformity area will decrease pain and limit the need for a surgical waiting period that is found with fusions. Although the toe is not as stable as with a fusion, in certain cases, an arthroplasty is the best option.


See our patients' before and after picture gallery of hammertoes surgeries here.



Why choose University Foot and Ankle Institute for Hammer Toe Treatment?

UFAI surgeons offer their revolutionary approach to the surgical treatment for hammer toes. We use a screw or absorbable pin for rapid healing and early weight-bearing.  There is often no need for a pin to stick out of the toe post-surgery, which may be a source for infection and rigid fixation.  Our goal is to get you back on your feet in the least invasive, quickest way possible.



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Thank you for all your care and support. After 5 years of pain, you took care of things permanently for me. I can't tell you what a joy it is to be able to walk or simply pick up my kid and not be in pain. I'm forever grateful that you were my doctor. Thank you for everything from the bottom of my heart. Miriam