What Are Toe Deformities?

Toe deformities are common conditions where one or more toes become abnormally bent or misaligned. They can affect comfort, balance, and how shoes fit—and if left untreated, may become painful and rigid over time.

 

The three most common types of Toe Deformities are:

1. Hammer Toe

• Bending occurs at the proximal interphalangeal joint (the first joint of the toe)

• Usually affects the 2nd toe

• Can be flexible at first, but may become stiff

 

2. Claw Toe

• Involves two joints: the toe bends up at the base (MTP joint) and down at the middle and end joints

• Often affects multiple toes at once, especially in people with neuromuscular disorders or long-standing foot imbalances

 

3. Mallet Toe

• Only the distal joint (end of the toe) is bent downward

• Common in the 2nd or 3rd toe

 

What Causes These Conditions?

• Ill-fitting shoes (tight, narrow, or high-heeled footwear)

• Imbalance in toe muscles and tendons

• Bunions pushing the toes out of alignment

• Flat feet or high arches

• Neurological conditions (e.g., diabetes, stroke, peripheral neuropathy)

• Arthritis

• Trauma or injury to the toe or foot

 

Signs & Symptoms

• Bent or curled toes

• Corns or calluses on top or tip of toes

• Pain when wearing shoes

• Redness, swelling, or irritation

• Difficulty walking or finding comfortable shoes

• In severe cases: open sores, nail changes, or pressure ulcers

 

Treatment Options

Your podiatrist will tailor your treatment based on flexibility, severity, and underlying causes.

 1. Footwear Modifications

• Wear shoes with a wide toe box and soft uppers

• Avoid high heels or pointed shoes

• Choose shoes with low heels, good cushioning, and extra depth

 

2. Padding & Offloading

• Use toe sleeves, foam pads, or gel cushions to reduce pressure and prevent corns

• Custom padding can protect joints from rubbing

 

3. Orthotics

• Custom or prefabricated insoles can redistribute pressure

• Orthotics can help correct biomechanical issues (e.g., flat feet, overpronation)

 

4. Toe Splints or Straighteners

• Used for flexible deformities to help realign the toes and reduce strain

• Often worn during the day in shoes or overnight

 

5. Exercises & Manual Therapy

• Toe stretches to improve flexibility

• Towel scrunches and marble pickups for strengthening toe flexors

• Massage and mobilisation for joint stiffness

 

6. Debridement of Corns or Calluses

• Performed painlessly in clinic to relieve pressure and discomfort

 

7. Medical Management

• Inflammatory or arthritic causes may require referral to your GP or rheumatologist

• Pain relief gels or topical anti-inflammatories may help temporarily

 

Surgical Options (For Rigid or Severe Cases)

• Surgery may be considered if:

• Deformity is fixed (rigid) and painful

• Corns or ulcers keep recurring

• You’re unable to wear shoes or walk comfortably

 

Surgical options include:

• Tendon release or transfer

• Joint fusion or resection

• Realignment procedures

 

We’ll refer you to a trusted foot and ankle surgeon if surgery is appropriate.

 

Prevention Tips

• Always choose well-fitting, supportive footwear

• Don’t ignore minor toe changes—early intervention prevents complications

• Stretch your toes regularly

• Avoid walking barefoot on hard surfaces if you have nerve issues

• Manage diabetes or other health conditions that affect your nerves or muscles

 

When to See a Podiatrist:

• Notice toes beginning to curl or drift

• Struggle to find shoes that fit comfortably

• Develop corns, calluses, or blisters on the toes

• Have toe pain, especially with shoes or walking

• Have diabetes or poor circulation and see toe changes

 

We’re Here to Straighten Things Out! Supporting every toe, every step of the way.

 

From your team at Toe-tal Podiatry