Hammer toe: causes, treatment, and prevention tips (including simple exercises)

If you notice a sore, swollen, or red toe that appears stuck in a bent position at the middle joint, you may be dealing with hammer toe. This condition causes the toe to remain curled or flexed, making it difficult to straighten. Hammer toe often develops gradually due to consistent pressure on the toe — typically from certain shoes or the way you walk — which causes the joint to bend differently. 

"Hammer toe can be uncomfortable for some people — though not everyone. If it does cause pain for you, there are a lot of effective ways to relieve discomfort, including targeted exercises for your toes and feet," says Caleb Wolters, PT, DPT, a physical therapist at Hinge Health.

Here’s a closer look at hammer toe: what it is, what causes it, what it feels like, and how you can treat it, including exercises recommended by Hinge Health physical therapists.

What is hammer toe?

Hammer toe is a condition that causes the toe to bend downward, making the middle joint stick up in a way that resembles a hammer. It most commonly affects the second, third, or fourth toe. Hammer toe develops when something — like tight footwear or the way you walk — forces the toe into a bent position repeatedly. 

“You may not even notice a mild hammer toe at first, because your muscles and tendons adjust and help your toe straighten back out,” says Dr. Wolters. “But if that pressure occurs repeatedly or over a long period of time, the muscles and tendons can tighten and shorten so your toe eventually gets ‘stuck’ in a curled position.” This doesn’t cause symptoms for everyone, but it can make walking, standing, and other everyday activities more difficult for some people. 

What about mallet toe or claw toe?

Hammer toe is different from conditions like mallet toe and claw toe. With mallet toe, the joint nearest the tip of the toe bends downward. Claw toe causes the base joint of the toe to bend upward and the middle joint to bend downward. Even though these conditions affect the toes in different ways, they often have similar causes and can usually be improved with non-surgical treatments like physical therapy.

Types of hammer toe

Hammer toe can vary in severity and is classified into different types based on how much you can move your toe:

• Flexible hammer toe: You can still move or straighten the joint. This early stage often responds well to exercises, stretches, and changes in footwear.

• Semi-rigid hammer toe: The toe becomes noticeably stiffer and is more difficult to straighten, but some movement is still possible. Symptoms may be more uncomfortable and limiting.

• Rigid hammer toe: The toe is fixed in a bent position and you cannot move it at the middle joint. This advanced stage may need surgery if other treatments are not effective.

Causes of hammer toe

There isn’t just one reason why hammer toe develops — instead, a mix of everyday habits, underlying conditions, and genetics can all play a role. These influences can lead to changes in the muscles, tendons, or joints in your toes, making them more likely to bend and stay in a flexed position. Here are some common causes of hammer toe: 

• Tight footwear. Wearing certain shoes can make hammer toe symptoms more noticeable. Shoes with a tight toe box — the front part of a shoe where your toes sit — are a common culprit. This might include high heels, pointed-toe shoes, some athletic shoes, ballet flats, and dress boots with a narrow front. “When your middle toes are crowded together for long periods, the muscles and tendons start to adapt,” explains Dr. Wolters. 

• Foot muscle weakness. When the muscles and tendons across the top of your toe are weak — often due to factors like aging, injury, or lack of foot movement — the muscles underneath your toe can tighten to compensate. “This extra stiffness increases your risk of developing hammer toe,” says Dr. Wolters.

• Toe trauma or injury. Stubbing, jamming, or breaking a toe can temporarily disrupt how the muscles and tendons around the joint work together. This can make the toe more likely to bend downward, increasing the chances of developing hammer toe.

• Other conditions. Conditions like osteoarthritis, rheumatoid arthritis, or type 2 diabetes can contribute to inflammation, joint stiffness, or nerve changes that increase your risk of developing hammer toe.

• Genetics and foot shape. Inherited differences in foot structure, such as having a longer second toe or a high arch, can make you more likely to develop muscle imbalances that contribute to hammer toe.

• Age. As you get older, the muscles and tendons in your feet naturally lose strength and flexibility, making it harder for your toes to stay straight. Reduced joint mobility and changes in foot structure with age can also increase the risk of hammer toe.

• Being female. Hammer toe is more common in women, likely because women more often wear shoes that crowd or compress the toes — such as high heels, pointed-toe shoes, and narrow flats, says Dr. Wolters. 

Symptoms of hammer toe

The earliest sign of hammer toe is usually a toe that appears curled or bent, often before any pain develops, says Dr. Wolters. Over time, you may experience:

• Pain

• Stiffness

• Swelling

• Corns or calluses on top of the toe

• Redness or other skin discoloration

Treatments for hammer toe

There are many ways to manage hammer toe, depending on your symptoms. Many people find relief with simple lifestyle changes, supportive footwear, and exercises that help strengthen the foot. In some cases, over-the-counter supports or medication can help reduce discomfort. Here are treatments Hinge Health physical therapists recommend: 

• Targeted exercises and physical therapy. Targeted exercises can help stretch and strengthen the muscles and joints in your foot, which may relieve symptoms and support your recovery. You can do these exercises at home, or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Stay active. Foot pain can make it tempting to rest or avoid movement, but staying active is important for healing. Physical activity increases blood flow to your feet and toes, which can help your hammer toe improve, says Dr. Wolters. Low-impact activities like swimming, biking, and rowing are especially good choices, since they boost circulation without putting extra pressure on your feet.

• Choose shoes with a wide toe box. Choose shoes with a wide, deep toe box to give your toes plenty of room. “I tell patients you should be able to play the piano with your toes,” says Dr. Wolters. For example, in running shoes, you should be able to wiggle your toes without feeling pressure from the top of the shoe. 

• Try a rocker bottom shoe. Rocker bottom shoes have a curved, rounded sole that helps your foot roll forward more naturally as you walk. “If you have trouble pushing up on your toes, these shoes can make it easier to walk and stay active with less pain,” says Dr. Wolters. 

• Try over-the-counter (OTC) supports. OTC toe pads can cushion your toes and relieve pressure, while shoe inserts or orthotics can provide extra support if you have flat feet or high arches. These simple additions can help make your shoes more comfortable and may reduce hammer toe discomfort.

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can perform your targeted exercises and stay active when you have toe pain. Other options include topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are ‌safe to take.

Surgery for hammer toe

If your hammer toe becomes so rigid that you can no longer move your toe, or if pain and discomfort persist despite conservative treatments, your doctor may recommend surgery as a way to correct the problem, says Dr. Wolters. Surgical procedures are typically considered a last resort when other options haven’t worked. 

Depending on your situation, procedures may include releasing or lengthening tight tendons, removing a small section of bone to restore the toe’s position (arthroplasty), or fusing bones in the joint to keep the toe straight (arthrodesis). Your healthcare provider can help you decide which procedure is right for you.

These exercises, recommended by Hinge Health physical therapists, are designed to stretch and strengthen your toe muscles while also improving flexibility. They can help release tight tendons and reduce the stiffness that contributes to hammer toe, making it easier for your toes to move comfortably. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

How to prevent hammer toe 

While anyone can develop hammer toe, there are steps you can take to reduce your risk and keep your feet healthy. Hinge Health physical therapists recommend the following tips:

• Make sure shoes fit you properly. Choose shoes with a roomy toe box so your toes have plenty of space to move and flex. Since foot size and shape can change over time, it’s helpful to get your feet measured regularly at a shoe store to ensure you’re wearing the right size.

• Limit high heels. High heels force your foot into a downward position and put extra pressure on the front of your foot and toes, says Dr. Wolters. The higher the heel, the greater the pressure. It’s okay to wear high heels occasionally, but try to limit them to a few hours at a time instead of all day. 

• Stretch your feet and toes regularly. Gentle stretching can help keep your toe muscles flexible and prevent stiffness that contributes to hammer toe. The exercises listed above are a great place to start.

• Manage other health conditions. If you have arthritis, diabetes, or other conditions that affect your feet, work with your healthcare provider to keep these conditions well controlled and reduce your risk of developing hammer toe.

When to see a doctor 

Hammer toe often improves on its own with conservative treatments. But if your hammer toe is severe, getting worse, or causing difficulty with daily activities, see a healthcare provider. It’s also a good idea to get care if you have:

• Persistent pain or swelling in your toe or foot

• Open sores, ulcers, or signs of infection (redness, warmth, pus, or fever)

• Difficulty walking or wearing shoes due to your toe position

• Numbness, tingling, or loss of sensation in your toe

• Hammer toe that becomes rigid and cannot be straightened

• Other foot changes along with a history of diabetes or poor circulation

PT tip: Go barefoot

Dr. Wolters recommends spending some time walking around barefoot each day. Giving your feet a break from shoes allows your toes to spread out naturally and encourages the small muscles in your feet to work more actively. “It will allow your feet plenty of space so that they — and you — can move with less pain,” he says. 

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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2. Uğur Şaylı, Elif Çiğdem Altunok, Melih Güven, Akman, B., Biros, J., & Ayşe Şaylı. (2018). Prevalence estimation and familial tendency of common forefoot deformities in Turkey: A survey of 2662 adults. Acta Orthopaedica et Traumatologica Turcica, 52(3), 167–173. doi:10.1016/j.aott.2018.01.003

3. Goransson, M., & Constant, D. (2021). Hammertoe. PubMed; StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK559268/

4. Walton, D., & Weatherford, B. M. (2024, September). Hammer Toe. OrthoInfo - American Academy of Orthopaedic Surgeons. Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/hammer-toe/