Claw toes and hammer toes

In summary: claw or hammer toes curl due to a tendon imbalance and worsen over time. While the toe is flexible, orthotics and suitable footwear can slow it down; when the deformity becomes fixed and bothersome, it is corrected with surgery, often minimally invasive.

Claw toes and hammer toes are very common deformities, and often go hand in hand with bunions or an overloaded forefoot. The curled toe rubs against the shoe, a callus forms, and what was an aesthetic nuisance becomes daily pain.

The good news: caught in time, surgery is almost never necessary. The key is understanding why the toe is curling — which is usually a gait issue — and acting on the cause, not just on the toe.

Why calluses appear on top of the toes

When a toe curls, the joint knuckle is raised and rubs against the shoe with every step. The skin defends itself by thickening, and thus the callus is born. It seems like a skin problem, but it is actually a mechanical problem: as long as the toe remains curled, the callus will return.

That is why the approach has two parts. Chiropody removes the callus and the immediate pain from rubbing. And in parallel, we must act on the cause — footwear, orthotics or, if the deformity is already fixed, correction of the toe — so the rubbing does not recur.

The same happens on the sole: when the toes claw, they pull the ball of the foot forward and leave it more exposed. This is where plantar calluses and pain under the ball of the foot come from, the metatarsalgia that so often accompanies these deformities.

Claw toes and bunions: often go together

It is no coincidence that they appear at the same time. When there is a bunion, the big toe deviates and stops doing its part of the work in pushing off the step. This load passes to the smaller toes, which are not designed to assume it: the tendons become unbalanced and the toes begin to curl.

That is why in the consultation we do not assess the toe in isolation, but the entire forefoot and the manner of walking. Correcting only the small toe, leaving the bunion and the gait as they were, is fixing the consequence and keeping the cause. When surgery is necessary, often both issues can be addressed in the same procedure, using minimally invasive techniques.

Simple gestures that help day to day

While treating the cause, there are things that add up. Choose shoes with a wide and high toe box, that do not press the toes from above. Walk barefoot at home when you can and move your toes: scrunching and stretching them, or trying to pick up a towel from the floor with them, keeps them active.

These are gestures that do not correct a deformity, but they help maintain the flexibility of the toes — and a flexible toe always has more treatment options than a rigid one.