HAMMERTOES Frequently Asked Questions

Hammertoes are painful. They rub on your shoes, they get calluses, they feel funny when you walk, and just generally hurt. There are three joints involved in digital deformities. They are the metatarsal phalangeal joint(MPJ), proximal interphalangeal joint (PIPJ) and  distal interphalangeal joint (DIPJ). 

Hammertoe is a deformity of the joints of the small toes, but the toe next to the big toe is the most commonly affected. If your toes are stuck in a bent or abnormal position, you might have hammertoes.

Hammertoe results when the tendons and muscles that hold your toes in place become unbalanced, allowing the underside to tighten and curl up your toe. This causes the middle joint to bend sharply upward. It starts as a mild deformity that remains pliable, but gets worse over time and becomes stiff, trapped in place, and difficult to treat.

What a weird name: Why hammertoes?? The toe bends and apparently to someone somewhere it resembles a hammer.  It does not look like a hammer to me but somebody thought it did so the name stuck.

There are three or four names for hammertoes. There are several names for contracted toes that describe which joints are contracted.

It really does not matter that much which joint is involved; they all can cause pain and difficulty with shoe gear.

Some studies estimate that hammertoes occur in 14% or people and in families with hammertoe genetic propensity is 61%.  They are also more common in females.

Several different factors cause the middle joint of any of your small toes to become flexed and bent upwards. Common causes include:

  • Nerve damage
  • Repeated wearing of high heels, tight shoes, or footwear with a pointed toe box
  • A traumatic toe injury
  • High foot arch
  • Pressure from a bunion
  • Tightened ligaments or tendons
  • Abnormal balance of the toe muscles

Genetics probably causes most hammertoes, however, they can be made worse or more painful by ill fitting shoes.

Most hammertoes are also associated with some muscle imbalance with the flexor tendons over power the extensor tendons, therefore, the toes curl down.

Many researchers think bad shoes cause hammertoes. However, there is a big difference between CAUSE AND AGGRAVATING a hammertoe.

I suppose if you wore a tight shoe every day over a long period of time, and left them on at night the toes would become adapted to a hammertoe position much like Chinese foot binding. That would be a cause. But if you are barefoot or use sandals frequently then shoe likely is not the only cause of the hammertoes; they just aggravate the hammertoes. That being said, good well fitting shoes with good biomechanical control should certainly decrease the risk of getting a hammertoe. There is no long-term research on this that I could find.  However, when  appropriate support and shoe fit is applied the tendency to curl the toes decreases dramatically.

Yes. Your risks of developing hammertoe increases as you grow older. Other risk factors include:

  • Family history of hammertoe
  • Your second toe is longer than your big toe
  • Certain diseases like arthritis and diabetes
  • Having thickened layers of skin like calluses or corns

Don’t hide behind your shoes anymore!

Millions of Americans suffer from hammertoe, but only a small fraction of them seek medical attention.

The more you ignore it, the harder and more painful it is to correct.

If you have a hammertoe, call today or make an appointment online with expert podiatrists Dr. Darren Silvester and Dr. Gregory Larsen at Next Step Foot & Ankle Clinic. The San Antonio-area practice has two convenient offices in Universal City and Pleasanton, Texas, to restore your feet.

Take the next step toward happy feet and schedule today!

Request Appointment >

quick links:

Ask about our minimally invasive way we treat hammertoes!



treatment options

Can conservative care help with my hammertoes?

Hammertoe procedures have to be carefully planned depending on which joints are involved and how severe the deformity are at those joints. Some deformities are flexible and some are rigid. This all has to be taken into consideration when considering what procedure is best to correct the deformity.


conservative treatment options

At Next Step Foot & Ankle Clinic, your doctor examines your toes. He may order an X-ray of your foot to examine the bone structure further. The result of the examination determines the best course of treatment.

If your hammertoe is still in its early stages, firstly, your podiatrist may show you how to correct it, secondly, advises you on changing your shoes and thirdly, assists you on getting special pads to accommodate the shape and size of your foot. Lastly, he might prescribe a pain reliever and the use of an ice pack to relieve soreness and swelling.

Your doctor ensures that your treatment plan is personalized to your unique situation and relieves your pain and discomfort fast and efficiently.



There are many different types of splints that help keep the toes straight. There was some you wear while sleeping an others in shoes. Some are designed to take pressure off certain areas of the toes to make them more comfortable.

Some are made to try and straighten the toes. They all are somewhat useful but become tedious quickly. There is no evidence that these straighten toes but they can make the toes more comfortable. Anecdotally, these splints to help straighten out hammertoes sometimes.



Orthotics change the way your foot interacts with the ground. It can make your foot more stable so that there is less gripping of the floor which contributes to hammertoe deformity for many patients.

At Next Step Foot and Ankle Clinic, we are the first to bring San Antonio and surrounding areas Custom 3D Orthotics with our FitStation by HP(Hewlett Packard), digitized for unparalleled accuracy.

Our FitStation provides thousands of data points on not only the pressure points of your foot standing still (like a cast would) and when your feet are in gait (a person’s manner of walking), giving the doctors a view of how your body as a whole is affecting each foot for your perfectly tailored fit.

Keep in mind, shoes that are narrow don’t work too well with orthotics.  



Diabetic shoes are a great option for people with toe deformities. You do not have to be diabetic to use the month course.

What they do provide is a very deep toe box.  This provided significant room for toes that are crooked and takes a lot of pressure off the offending locations.

Additionally, it allows for the use of toe splints to accommodate these deformities if needed.

A few years ago most diabetic shoes were so ugly nobody would wear them, thankfully, that is not the case anymore. Diabetic shoes now come in a lot of very attractive styles.



Sometimes, physical therapy is required to relax your tightened tissues, keep your joints flexible, and rebuild your strength. In a severe case of hammertoe where your toe is too stiff, you may need surgery to release the tightened structures.


minimially invasive

treatment & surgery

for hammertoes


treatment & surgery options

Dr. Silvester and Dr. Larsen specialize in many advanced minimally and non-invasive treatments, and if necessaryadvanced minimally invasive and traditional surgical techniques with patient proven success stories.

Some of those are used to treat your hammertoes, such as:

At the Next Step Foot and Ankle Clinic 95% of our hammertoe surgeries are performed with a minimally invasive technique.  This involves the use of local anesthetic and a needle.

NO SCALPEL, NO BIG INCISION, NO LONG RECOVERY and can be performed in a few minutes, requiring only 2 days recovery.

This procedure is performed with a needle.  A dressing is applied.  The patient leaves the dressing on for 2 days. Once the patient removes the dressing they are generally able to wear regular shoes as long as they are not too tight.  They return to normal activities for the most part.  In some cases, the toes feel bruised for a few days.  No pins or hardware are needed.  Occasionally some splinting is necessary and very rarely, more traditional surgery may be necessary.  The biggest advantage of minimally invasive hammertoe surgery, besides the much shorter recovery, is that we have observed a more natural appearance of the toe after surgery.  The toe assumes its correct clinical alignment in most cases.  Your  toes just look normal.  No scar is seen.  The length of the toe remains the same.  This usually results in a very cosmetically pleasing appearance.

Rarely bone work may be needed.  If such is the case that can also be done with minimally invasive techniques.  The recovery is a little longer because you have to wait for bones to heal.  But the recovery of a minimally invasive technique is still usually  quicker than traditional hammer toe surgery.

Don't let those pesky hammertoes stop you from living your best life!


success story


for Hammertoes

Get back on your feet and your shoes in just 3 DAYS!

Dr. Silvester talks about our minimally invasive way we treat hammer toes. Getting you back on your feet and in your shoes in just 3 days!


Call us direct at 210-375-3318.

Fill out our quick Appointment Request.

Click the CHAT button on the bottom right.

What Our Patients
Say About Us

For more Google reviews, click here.