A hammertoe is a deformity in which one of the smaller toes — usually the second, third, or fourth — bends abnormally at the middle joint, causing it to buckle upward like an inverted "V." Hammertoes often begin as mild and flexible, meaning the toe can still be manually straightened. Left alone, though, the joint can stiffen into a rigid deformity that no longer responds to simple measures, so treating hammertoe early — and choosing the right treatment for how far it has progressed — matters.
Patients often tell us the same thing: padding the area gets harder, calluses keep coming back, and normal shoes stop fitting comfortably. Below, our podiatrists in Farmington and South Ogden explain how hammertoes progress, how we diagnose flexible versus rigid deformities, and the full range of nonsurgical and surgical options available.
What is a hammertoe, and how does it progress?
A hammertoe develops when the tendons that control a toe fall out of balance, pulling the middle joint into a bent position. In its earliest stage, the toe is flexible — it can still be pushed back into a normal position by hand or with splinting. Over time, without correction, the joint tissues tighten and the deformity can become rigid, meaning the toe stays bent even when you try to straighten it.
As a hammertoe progresses, padding the affected area becomes more difficult and shoes may no longer fit comfortably. Friction against the top of the bent joint frequently leads to painful corns or calluses, and the toe can rub against neighboring toes or the top of the shoe with every step.
How is hammertoe diagnosed?
Diagnosis starts with a hands-on exam. Your podiatrist will gently test whether the toe can still be manually repositioned (flexible) or whether it is fixed in place (rigid) — this distinction drives every treatment decision that follows. We also review:
- Your footwear and how it may be contributing to friction or pressure
- Activity level and how much time you spend on your feet
- Any treatments you have already tried
- Pain during movement, both at rest and with weight-bearing
Weight-bearing X-rays are typically taken to look for arthritis in the joint, subluxation (partial dislocation), and any rotational component to the deformity. This imaging helps confirm how advanced the hammertoe is and whether nearby joints, such as the ball of the foot, are also affected — a common finding alongside conditions like bunions.
What are the goals of hammertoe treatment?
Regardless of severity, treatment is built around three objectives:
- Correcting toe mechanics by realigning the joint so it functions and sits normally
- Relieving pressure from the affected area to reduce pain and friction
- Preventing recurrence of the deformity and the calluses it causes
Nonsurgical treatment options
Flexible hammertoes, and many mild cases, respond well to conservative care. Options include:
- Footwear changes — shoes with a wider, deeper toe box reduce friction and pressure
- Padding or toe splints to cushion the joint and encourage better toe positioning
- Physical therapy to stretch tight tendons and strengthen the small muscles of the foot
- Corticosteroid injections to calm inflammation and pain in the joint
- Custom orthotics to improve how weight is distributed across the foot — see our custom orthotics options
Surgical treatment options
When a hammertoe becomes rigid, or when conservative care no longer controls pain, surgery can permanently correct the deformity. The right procedure depends on how advanced the joint changes are:
- Arthroplasty — a small portion of the joint is removed, allowing the toe to straighten while retaining some flexibility
- Arthrodesis — the joint is permanently fused in a straightened position, typically reserved for more rigid or recurrent deformities
Your surgeon will recommend the approach best suited to your toe's flexibility, the degree of deformity on X-ray, and your activity goals.
What does recovery from hammertoe surgery look like?
Initial recovery typically takes about six weeks, during which you will wear a protective surgical shoe or boot and gradually return to normal footwear as swelling improves. Complete resolution of swelling can take longer — often three to six months — which is normal and does not mean healing has stalled. Your podiatrist will guide you through a step-by-step return to regular activity and shoes.
When should you see a podiatrist about a hammertoe?
See a podiatrist as soon as you notice a toe beginning to bend or you develop a recurring corn or callus on top of a joint — catching a hammertoe while it is still flexible gives you the most treatment options and the best chance of avoiding surgery. Seek care sooner if the toe is painful, red, or draining, as this can indicate infection, especially in people with diabetes or poor circulation. When you are ready, you can request an appointment at either of our Northern Utah offices.
Medically reviewed by the physicians at Wasatch Foot & Ankle Institute. Our board-certified, fellowship-trained podiatrists provide foot and ankle care in Farmington and South Ogden, Utah. This article is for general education and is not a substitute for an in-person evaluation.