Claw toe

The toes have joints at each segment: the metatarsophalangeal joint at the base, the middle joint beyond it, and the joint near the tip. In claw toe, the base joint lifts upward and the other two joints bend downward, making the whole toe curl into a hook-like shape.

Hammer toe involves bending at just the middle joint. In contrast, claw toe involves several joints curling together, leaving very little of the toe in contact with the ground and making the tip point down into it.

When the joint at the base of the toe lifts upward, the bone head beneath the forefoot becomes relatively more prominent downward. This can concentrate weight on the area during walking, causing a feeling of pressure.

Toes curl when the balance of strength between the muscles that bend and straighten them changes. When the pulling forces of the tendons on top of the toes and the muscles underneath become unbalanced, the toes are continually pulled in one direction.

• High-arched feet — Pes cavus can be accompanied by claw-like curling of the toes. This may also be associated with muscle or nerve conditions.
• Tight shoes — Shoes with narrow or shallow toe boxes keep the toes pressed into a bent position for long periods. Repeatedly holding this position can make the toes more likely to become stiff and unable to straighten.
• Weak toe muscles — The balance can also be disrupted when the muscles become less able to keep the toes flat against the ground while bearing weight.

• Calluses or corns develop on the tips of the toes or on top of the joints at their bases. They can also develop on the sole. See Plantar calluses and corns.
• The toes rub against the inside of the shoes, causing discomfort, and the shoes feel tight.
• It feels as though the toes cannot make proper contact with the ground.
• People often describe their toes as “curled up and stiff.”

In the early stages, the toes can be straightened by hand, but over time, the joints may become stiff and difficult to straighten. That is why regularly straightening the toes as part of early care is important.

• Choose shoes with wide, deep toe boxes. Having room for the toes to straighten inside the shoes reduces pressure. Be sure to check the forefoot width and toe-box height.
• Straighten your toes every day. While seated, gently straighten your toes with your hands, then spread them wide and bring them back together a few times. Do not force the movement to the point of pain.
• Try towel curls. Pulling a towel placed on the floor toward you with your toes can activate the muscles in the sole (Intrinsic foot muscles).
• Reduce pressure on the forefoot. Cushioned insoles or toe pads can redistribute pressure away from areas where calluses form.
• Care for calluses. Rather than aggressively cutting away thickened calluses, try keeping them soft with moisturizer after bathing.
• Make time to walk barefoot. At home, take off your shoes and spend some time placing your weight on your feet with your toes straightened.

• When the toes will not straighten and are becoming increasingly stiff
• When calluses or corns keep returning and walking is painful
• When the skin on the toes peels or develops wounds that do not heal well
• When only one foot suddenly becomes deformed, or the foot develops numbness or tingling and weakness

In these cases, see a professional who can assess both the structure of the foot and nerve function.