Crooked Toes: A collection of conditions characterized by bent toes.
Crooked toes are a common health problem, and there are several different types of crooked toes possible. The specific type of crooked toe a person may develop depends on the degree and direction of deviation in the affected toe’s joints. In some cases, the abnormal toe alignment is not permanent, and the toe may be realigned using conservative care techniques. Note: Crooked toes are extremely rare in shoeless populations or in groups of people who do not wear conventional footwear, with its many injurious design features.
Types of crooked toes include:
Hammertoe: A hammertoe is a crooked toe that is flexed to an abnormal degree at the first toe joint, or proximal interphalangeal joint. Hammertoes may affect any of the toes, and they often begin as mild deformities and become more severe over time. Hammertoes are usually flexible in the initial stages but may become rigid if they are not treated in an appropriate and timely manner.
Claw Toe: A claw toe is a crooked toe that is flexed to an abnormal degree at both the first (proximal interphalangeal) and second (distal interphalangeal) toe joints. It’s common for claw toes to dig into the soles of shoes, causing painful calluses to develop. This crooked toe problem usually gets worse without treatment and may cause irreversible deformities over time.
Mallet Toe: A mallet toe is a crooked toe that is flexed to an abnormal degree at the last toe joint (distal interphalangeal joint) only. The rest of the toe is straight. Mallet toe is commonly caused by shoes that possess toe box taper and heel elevation. The forces that these shoe features place on the forefoot cause unnatural cramping and bending of the toes.
Adductovarus Toe: Adductovarus toe is a crooked toe that has moved under an adjacent toe. This toe problem is commonly seen in the fourth and fifth toes, and it is a direct result of wearing shoes with tapering toe boxes. This condition is seen to some degree in many shoe-wearing people. Unshod individuals—people who do not wear shoes or conventional footwear—rarely experience this health problem.
Overlapping Toe: Overlapping toe is a condition in which one of the toes turns inward and lies on top of an adjacent toe. The second and fifth toes are the ones most commonly affected by this type of crooked toe. If the second toe overlies the big toe, this can cause rubbing inside the shoe, which in turn may cause wounds or sores to develop on the second toe.
Curly Toe: Curly toe is a crooked toe in which the most distal part of the toe—the toe segment located furthest away from the body—is flexed and curved to one side of the foot. Curly toes may be particularly common in newborns, and most curly toes spontaneously resolve before age six. In some cases, curly toes may cause pressure-related symptoms in shoe-wearing individuals later in life.
Signs & Symptoms
Some of the most common signs and symptoms associated with crooked toes include:
- Open sores
- Inflammation and redness
- A burning sensation in the affected toe
- Toe pain or irritation when wearing shoes
- Toe contracture, or permanent toe shortening
- A thickening of the skin between the toes, on the ball of the foot, or elsewhere
Inappropriate footwear is one of the leading causes of crooked toes. Shoes that possesses heel elevation, rigid soles, tapering toe boxes, and toe spring force the toes into an unnatural configuration and encourage muscle and tendon imbalances in the foot and lower leg. In some cases, crooked toes may be associated with past foot trauma. Genetics may play a role in this health problem in some individuals too.
The best strategy to treat or prevent crooked toes is to use foot-healthy footwear that allows the foot to function like a bare foot inside the shoe. Conventional shoes, including most running shoes, will hasten the progression of a crooked toe, as the design features included in most conventional models create an imbalance in the foot flexor and extensor muscles, as well as an imbalance in the four layers of muscles (intrinsic muscles) within the foot. Intrinsic foot muscles help stabilize the toes during walking and standing.
Other helpful natural strategies for crooked toes include:
- Physical therapy
- Toe joint manipulation
- Instrument-assisted soft tissue mobilization (e.g., Graston, gua sha, etc.)
- Certain stretches or exercises (e.g., Toe Extensor Stretch, Hammertoe Stretch, etc.)
Every attempt should be made to spread the toes when going barefoot. A toe-spacing product, such as Correct Toes, is a powerful tool that can be worn inside men’s and women’s foot-healthy shoes, over toe socks, or on bare feet to help realign the toes to their correct anatomical position, strengthen the muscles and tendons that attach to the toes, and increase the stability of the forefoot.
Individuals who experience any of the above-mentioned crooked toe syndromes should consider visiting a naturally-minded podiatrist or other appropriate foot care professional. A physician can offer additional strategies to help correct or reduce the progression of the crooked toe problem. The longer the crooked toe problem exists, the greater the likelihood it will become permanently rigid and require more extensive—and invasive—treatment, including surgery.
Surgery, when required, is used to help straighten the crooked toe and balance the pull of tendons surrounding the affected toe joint(s). Pins or wires are sometimes required to keep the toe in its correct position while it is healing. Please note that surgery may not provide a complete correction of the crooked toe, and that the problem may return if a person continues to use the same footwear that contributed to the condition in the first place. Please see our article that lists six ways to restore foot health after surgery for more info on this topic.