The trouble usually starts with one shoe. The knuckle of the second toe rubs against the top of it, a corn forms, and a pair that used to be comfortable gets pushed to the back of the closet.
Then another pair joins it.
If you are a senior with a toe that has started to curl, you have probably wondered whether it can be coaxed straight again or whether it is headed for an operation.
If you are a caregiver, the first sign may not be the toe at all. It may be a parent who wears house slippers to the grocery store, or a favorite sneaker with a slit cut into the top.
The answer depends on something you can check at home in a few seconds, and it is not how bad the toe looks.
Quick Answer: Can You Fix a Hammertoe Without Surgery?
Often you can manage one without surgery, but managing and fixing are not the same thing. A hammertoe that still straightens when you gently press it flat usually responds to roomier shoes, padding, splints and toe exercises, which ease pain and help keep it from stiffening.
A toe that has become rigid will not be straightened by exercise.
Non-surgical care can still make a rigid toe more comfortable, mostly by giving it room. When pain continues despite that, surgery becomes a reasonable next step rather than a failure.
What a Hammertoe Is, and How It Differs From Claw Toe and Mallet Toe
A hammertoe bends at the middle joint, so the toe rises in the center and points down at the tip. The American Academy of Orthopaedic Surgeons describes it as a deformity of the second, third or fourth toe that ends up shaped like a hammer.
Two close relatives often get confused with it.
- Claw toe bends at both the middle and end joints. Cleveland Clinic lists nerve damage from diabetes and rheumatoid arthritis among its causes, which makes it worth a medical look rather than a home fix.
- Mallet toe bends only at the last joint, the one nearest the toenail.
The label matters less than one practical question about the toe.
The Test That Decides Your Options: Does the Toe Still Straighten?
Hammertoes start out flexible. OrthoInfo, the patient site of the American Academy of Orthopaedic Surgeons, notes that left untreated they can become fixed and require surgery.
Cleveland Clinic sorts them into stages.
- Flexible. A curl is visible, but the toe still bends and straightens.
- Semi-rigid toes are noticeably stiff and hard to uncurl.
- A rigid hammertoe is frozen in its curled position and cannot be uncurled at all, and Cleveland Clinic describes these as the most likely to need surgery.
You can get a rough sense of this yourself. Sitting down, gently press the raised knuckle toward the floor with a fingertip and see whether the toe lies flat without pain.
If it does, you are in the territory where shoes and exercise have the most to offer.
If it barely moves, that is useful information too. A podiatrist or foot and ankle surgeon can confirm it on exam.
Caregivers of a parent with diabetes or numb feet should leave this check to a clinician. Someone who cannot feel their toes well cannot tell you when the pressure is too much.
Why Toes Curl: Shoes, Muscles, and Everything Else
OrthoInfo traces hammertoe to an imbalance in the muscles and tendons that normally hold the toe straight. Shoes that narrow toward the front push the smaller toes into a bent position, and high heels add pressure by driving the foot down into the front of the shoe.
Cleveland Clinic explains what happens next. Over time the muscles and tendons adjust to the cramped position and tighten, which is how a flexible toe becomes a stiff one.
Shoe length may matter as much as width, and that surprises most people.
In a study of 176 older adults with an average age of 80, Menz and Morris found that most wore shoes narrower than their feet. Narrow shoes were linked to bunions and corns, but it was shoes that were too short, both indoor and outdoor pairs, that were linked to deformities of the smaller toes like hammertoe.
A 2018 review by Buldt and Menz points out that this was a single study taken at one point in time, so it shows a link rather than proof that short shoes bent the toes. It is still a good reason to check length, including on the slippers worn all day at home.
Shoes are not the whole story.
Mayo Clinic lists women as more likely to develop hammertoe, along with people who have arthritis or diabetes, and notes that genes play a part. Cleveland Clinic adds naturally long toes, high arches, flat feet and bunions.
It is common. In the Framingham Foot Study of 3,189 adults with an average age of 66, hammertoes showed up on 16.2 percent of the feet examined.
What the Evidence on Non-Surgical Treatment Shows
Most pages promising to fix hammertoe without surgery skip this part.
The research is thin. A 2025 literature review by Colò and colleagues found that shoe changes and orthoses may relieve symptoms in most cases, yet concluded that none of them are permanent solutions to the deformity.
A 2024 systematic review of claw toe by Mayagoitia-Vázquez and colleagues listed silicone pads, taping, wide toe box shoes and botulinum toxin injections as the non-surgical options. The authors wrote that conservative treatment should be preferred over surgery, and that remarkably little is known about how the foot works after surgical correction either.
So the realistic goal of non-surgical care is a toe that hurts less and stiffens more slowly. No study found for this article showed exercises or splints permanently straightening a hammertoe, so be wary of any product that promises it.
Step One: Give the Toe More Room
Shoes come first because they are the one change every source agrees on.
OrthoInfo recommends avoiding tight, narrow, high-heeled shoes and choosing a pair with enough length and a roomy toe box. Cleveland Clinic asks for a toe box that is wider and deeper, since a hammertoe takes up height as well as width.
When you try a pair on, look for these.
- A toe box tall enough that the raised knuckle does not touch the top of the shoe
- Width across the front that matches the widest part of your foot
- Enough length. This is the measurement Menz and Morris tied to smaller-toe deformities, and it is easy to overlook in a shoe that feels snug in a good way.
- A low heel and a cushioned sole, both on the footwear list in the Colò review
Our guide to footwear that helps seniors prevent falls covers fit and grip in more detail, including the trouble with house slippers.
People with diabetes may get help with the cost. Medicare Part B covers one pair of extra-depth shoes with three pairs of inserts each year, or custom-molded shoes with two pairs of inserts, for people with diabetes and severe diabetes-related foot disease such as a deformity.
The doctor treating the diabetes has to certify the need and a podiatrist or other qualified doctor orders the shoes, with the usual 20 percent coinsurance after the Part B deductible.
Pads, Splints, Tape, and Toe Spacers
None of these change the shape of the toe. What they can do is take pressure off the spot that hurts.
Cleveland Clinic lists cushioning pads, medical tape and over-the-counter or custom orthotics among its non-surgical options. OrthoInfo mentions commercial straps, cushions and non-medicated corn pads.
Notice the word non-medicated. Anyone with diabetes or poor circulation should ask a podiatrist before putting any corn treatment on a toe, and our guide to common foot problems in older adults covers safe corn and callus care.
Splints have one small trial behind them.
In a 2012 randomized trial from Thailand, Chadchavalpanichaya and colleagues gave 36 people with hammer or claw toes either an adjustable toe splint plus shoe advice, or shoe advice alone. After two weeks, the splint group reported more relief of pain at the ball of the foot and the top of the toes, while two people developed toe abrasions from the splint.
That is a two-week pain result in a small group, not evidence that splints straighten toes.
Taping has even less behind it. Beyond its mention in the reviews above, the kinesiology taping evidence found for this article was a single case report.
Toe spacers, the gel separators that sit between the toes, are sold heavily as a hammertoe fix. None of the reviews cited here reported a trial of spacers for hammertoe, so if one feels good, use it for comfort and ignore the promise on the box.
If you are a caregiver helping with any of these, check the skin under any pad or splint once a day for redness or rubbing. That matters most for someone who cannot feel their feet well.
Toe Exercises: What They Can and Cannot Do
This is the part people most want to work, and it deserves a straight answer.
OrthoInfo includes manual stretching, toe pickups and towel curls among the non-surgical treatments for hammertoe. No trial found for this article tested whether those exercises reverse a hammertoe, so their realistic job is keeping a flexible toe flexible and the foot muscles working.
A simple home routine based on the OrthoInfo foot and ankle program looks like this. OrthoInfo advises warming up with 5 to 10 minutes of low-impact activity first and stopping any exercise that causes pain.
- Gentle manual stretch. Sitting with the foot resting across the other knee, hold the toe and ease it toward straight, keeping it there for about 30 seconds without forcing it. A few times a day is a typical starting point in a home program.
- Marble pickup: place 20 marbles or cotton balls on the floor and move them one at a time into a bowl using only your toes, 20 repetitions daily.
- For towel curls, sit with both feet flat, grab the middle of a small towel with your toes, curl it toward you and relax. OrthoInfo lists 20 repetitions daily.
One finding should shape how you approach these.
In a 2016 trial, Mickle and colleagues randomly assigned 85 adults aged 60 to 90 to a supervised, progressive resistance program for the foot muscles or to home-based exercise for 12 weeks, with a separate control group for comparison. Toe strength rose by up to 36 percent in the supervised group and did not change in the home or control groups.
The supervised group also improved its single-leg balance time and rated its foot health better.
Those participants were not chosen because they had hammertoes, so the trial says nothing about straightening a toe. It does suggest that a sheet of exercises done alone may not build much strength, and that steady progression with supervision is where a physical therapist earns a place in the plan.
Why Toe Strength Matters Beyond the Toe
For older adults, a curled toe is not only a shoe problem.
In a 2009 study, Mickle and colleagues examined the feet of 312 adults aged 60 to 90 and then tracked falls for a year. The 35 percent who fell had weaker toes and were more likely to have deformities of the smaller toes, with a relative risk of 1.32.
That is a link, not proof that hammertoes cause falls. The authors point out that toe strength helps with balance, which is why a good plan for a hammertoe looks at the whole foot and leg.
If unsteadiness is part of the picture, our set of balance exercises seniors can do at home pairs well with the toe work.
Caregivers, watch how a parent walks in their everyday house shoes rather than the good pair. A shuffle, or a habit of rolling onto the outside of the foot to protect a sore toe, is worth mentioning at an appointment.
When Surgery Becomes the Right Call
Needing surgery is not a sign that you did the exercises wrong.
OrthoInfo recommends surgery when the toe joint is rigid and no longer moves, or when non-surgical treatment does not relieve symptoms. The Mayagoitia-Vázquez review adds a caution in the other direction, that surgery should be chosen because of pain and discomfort rather than appearance alone.
OrthoInfo describes several approaches, from lengthening or transferring a tendon to joint fusion. In a fusion, part of the joint is removed and the toe is held straight with a pin while it heals.
Recovery is usually measured in weeks. OrthoInfo notes stiffness, swelling and redness in the toe for up to 4 to 6 weeks, and that you can usually put weight on the foot right away, though limiting activity helps it heal.
People with diabetes have one more option worth knowing about. For someone with diabetes, a hammertoe that is not yet rigid, and a callus, nail change or pre-ulcer at the tip of that toe, the International Working Group on the Diabetic Foot suggests considering a digital flexor tenotomy.
That procedure releases the tendon pulling the toe down, to help prevent a foot ulcer rather than to improve how the toe looks. It is a conditional recommendation, meaning the group judged the benefit likely but the evidence limited.
What a Doctor Will Typically Check
The hands-on exam does most of the work.
- Whether each joint still straightens. This is how flexible, semi-rigid and rigid are told apart, and it drives every decision after it.
- Corns and calluses on top of the toe, at its tip, or under the ball of the foot
- The shoes you actually wear, including the ones you keep by the bed
- Circulation and feeling in the feet, which matter in anyone with diabetes and before any surgery.
- Bunions or other changes that may be crowding the smaller toes
- Toe strength and balance, which a physical therapist may test with a timed single-leg stance
If you are a caregiver, bring the shoes your parent really wears every day. A worn slipper with the shape of the toe pressed into it tells the clinician more than any description will.
What NOT to Do
- Do not force a stiff toe straight. A stretch should feel like a stretch, and OrthoInfo advises stopping any exercise that hurts.
- Do not cut corns or calluses with a blade at home, especially with diabetes or poor circulation.
- Do not put tape, a pad or a splint over broken skin.
- Do not wait on a toe that turns red, hot or swollen, or starts to drain, particularly with diabetes. That needs prompt medical attention.
- Do not count on spacers or splints sold online to straighten a toe that has already gone rigid.
- Do not rule out surgery because you read that it can be avoided. For a rigid, painful toe, it may be the faster route back to comfortable walking.
Frequently Asked Questions
Can physical therapy fix a hammertoe?
Physical therapy cannot reverse a rigid hammertoe. What it can do is keep a flexible toe flexible, and build foot strength and balance through progressive, supervised exercise.
Can a hammertoe straighten on its own?
Not in any study found for this article. A flexible hammertoe can stay flexible with roomier shoes and regular stretching, but the usual goal is less pain and slower stiffening rather than a return to straight.
How long do toe exercises take to work?
There is no trial-based timeline for hammertoe itself. In the Mickle strength trial, older adults trained for 12 weeks before toe strength was measured again, which is a fair window for judging whether a routine is helping.
My father refuses to give up his old slippers. What can I do?
Skip the argument about the toe and make it about fit. Measuring both feet and shopping for one replacement pair with a deeper toe box is a much smaller ask than giving up a favorite.
If he has diabetes, ask his doctor whether he qualifies for Medicare-covered extra-depth shoes.
Are hammertoes and bunions related?
Often. Cleveland Clinic lists bunions as a risk factor for hammertoe, and a big toe drifting toward the others leaves less room for the second toe.
Final Thoughts for Adults Over 50
A hammertoe gives an early warning that many foot problems do not, a stage where the toe still straightens. That window is when shoes and exercise have the most to offer.
If you are a senior, press the knuckle down gently now and then and notice whether it still lies flat. A toe that is getting harder to straighten is a reason to see someone sooner rather than later.
If you are a caregiver, look at the shoes before you look at the foot. And if your parent’s toe has already gone rigid and still hurts in good shoes, choosing surgery is a reasonable decision, not a defeat.
Medical Disclaimer
This article is for general education and does not replace personalized medical advice. A painful or changing toe should be evaluated by a podiatrist, foot and ankle surgeon or physician, and anyone with diabetes, poor circulation or numb feet should have foot changes checked before trying home treatments.
Seek prompt medical care for a toe or foot that becomes red, hot, swollen or starts to drain, or for any sore on the foot that does not heal.
You Might Also Be Wondering
- Exercises for peripheral neuropathy, worth reading if numb feet make it hard to tell when a shoe is rubbing.
- How to strengthen your ankles with a resistance band, the natural next step up the leg from toe work.
- How to tell whether physical therapy is the right next step.
Medical References
- American Academy of Orthopaedic Surgeons, OrthoInfo. Hammer Toe.
- American Academy of Orthopaedic Surgeons, OrthoInfo. Foot and Ankle Conditioning Program.
- Cleveland Clinic. Hammertoes.
- Cleveland Clinic. Claw Toes.
- Mayo Clinic. Hammertoe and Mallet Toe: Symptoms and Causes.
- Menz HB, Morris ME. Footwear characteristics and foot problems in older people. Gerontology. 2005;51(5):346-351.
- Buldt AK, Menz HB. Incorrectly fitted footwear, foot pain and foot disorders: a systematic search and narrative review of the literature. J Foot Ankle Res. 2018;11:43.
- Hagedorn TJ, Dufour AB, Riskowski JL, et al. Foot Disorders, Foot Posture, and Foot Function: The Framingham Foot Study. PLoS One. 2013;8(9):e74364.
- Colò G, Fusini F, Melato M, et al. The effectiveness of shoe modifications and foot orthoses in conservative treatment of lesser toe deformities: a review of literature. Musculoskelet Surg. 2025;109(3):225-232.
- Mayagoitia-Vázquez JJ, López-López D, Miguel-Andrés I, et al. A systematic review of the claw toe deformity: What is known and what is needed apart from surgical procedures. Int Wound J. 2024;21(10):e70073.
- Chadchavalpanichaya N, Katchamart W, Charatrungolan T, Nualnim P. The efficacy of adjustable toe splint on decreasing metatarsalgia in patients with lesser toe deformity: a prospective, randomized single-blinded controlled trial. J Med Assoc Thai. 2012;95(12):1575-1582.
- Mickle KJ, Caputi P, Potter JM, Steele JR. Efficacy of a progressive resistance exercise program to increase toe flexor strength in older people. Clin Biomech. 2016;40:14-19.
- Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele JR. ISB Clinical Biomechanics Award 2009: toe weakness and deformity increase the risk of falls in older people. Clin Biomech. 2009;24(10):787-791.
- Bus SA, Sacco ICN, Monteiro-Soares M, et al. Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update). Diabetes Metab Res Rev. 2024;40(3):e3651.
- Medicare.gov. Therapeutic shoes and inserts.
