Hammertoes
A hammertoe is a toe that bends downward at the middle joint instead of pointing forward. It starts flexible and becomes rigid over time if left untreated. Early intervention gives you the most options.
Symptoms
- Visible downward bend of one or more toes
- Pain or irritation when wearing shoes
- Corns or calluses on the top or tip of the toe
- Difficulty finding comfortable footwear
- Restricted movement of the affected toe
Who Gets It
Hammertoes develop from muscle imbalance — when the tendons controlling the toe shorten and tighten. Contributing factors include tight or narrow shoes, toe injuries, arthritis, and genetic predisposition. People with bunions are also more likely to develop hammertoes in adjacent toes as the big toe crowds them.
Hammertoes affect people of all activity levels, but tight cycling shoes and narrow running shoes can accelerate the condition in athletes. Austin's older active population — particularly those who've been on their feet for decades — often presents with both hammertoes and bunions developing together.
Treatment
Dr. Wokasien starts with conservative approaches:
- Toe splints or pads to realign and cushion
- Footwear recommendations with adequate toe box depth
- Exercises to strengthen and stretch toe muscles
- Custom orthotics to correct underlying biomechanics
- Corn and callus management
For rigid hammertoes that don't respond to conservative care, surgical correction straightens the toe permanently. Dr. Wokasien performs this at four Austin-area hospitals.
When to Call
A flexible hammertoe has multiple treatment options. A rigid one often requires surgery. Call (512) 250-0444 while you still have choices.
Frequently Asked Questions
What's the difference between a flexible and rigid hammertoe?
A flexible hammertoe can still be straightened manually — the joint moves. A rigid one is locked in the bent position. Flexible hammertoes respond well to conservative treatment. Rigid ones typically need surgery to correct. Catching it early, while the joint is still flexible, keeps your options open.
Will my hammertoe straighten on its own?
No. Once the tendon imbalance develops, it doesn't self-correct. Without treatment, flexible hammertoes gradually become rigid. Conservative care can slow progression and manage discomfort, but the deformity doesn't reverse.
Can changing my shoes help?
Shoes with a wide, deep toe box reduce the pressure that accelerates the condition. Tight or narrow footwear — especially shoes with pointed toes — squeeze the toes into positions that worsen the deformity. Footwear changes alone won't fix a hammertoe, but they reduce pain and slow progression.
What does hammertoe surgery involve?
The procedure straightens the toe by releasing the tightened tendon and sometimes fusing or reshaping the joint. Recovery takes several weeks, and Dr. Wokasien will walk you through what to expect. Surgery is considered only after conservative measures haven't provided adequate relief.
I have a corn on top of the bent toe. Is that related?
Yes — corns on the top of a toe are almost always caused by the toe rubbing against the shoe. The corn is a symptom of the hammertoe, not a separate problem. Treating the corn without addressing the hammertoe means the corn will return.
My second toe is longer than my big toe. Does that increase risk?
It can. A longer second toe is more vulnerable to being compressed by footwear, which increases hammertoe risk. It also increases the likelihood of developing a corn at the tip of the toe. Dr. Wokasien can assess your foot structure and tell you whether preventive measures make sense.
Are hammertoes related to bunions?
Often, yes. A bunion shifts the big toe inward, which can push the second toe up and out of alignment. It's common to develop a hammertoe adjacent to a bunion. Treating both conditions together usually produces better long-term results.