Flexible vs. Rigid Hammertoe: How to Know the Difference

If you’ve noticed one of your toes starting to curl or bend oddly, you might be dealing with something called a hammertoe, a condition that affects over 8% of adults. It starts off as a mild change, but over time, hammertoe can become painful and make walking or wearing shoes difficult.

One of the most important things to understand about hammertoe is whether it’s flexible or rigid. Knowing the difference can guide your treatment and help prevent future problems. 

At Mill Creek Foot & Ankle Clinic, our board-certified foot and ankle surgeon, Joseph Hall, DPM, and our team help patients figure out what’s going on with their feet and what to do about it.

Hammertoe basics

A hammertoe is a deformity where your toe bends downward at the middle joint, most often in the second, third, or fourth toe. This creates a shape that looks like a hammer. It develops when the muscles and tendons that control toe movement become imbalanced. Over time, this imbalance pulls the toe into a bent position.

The problem usually develops slowly. At first, the toe might move normally, but as it progresses, it can become stiff, painful, and more difficult to treat.

There are several reasons hammertoes develop, most commonly:

• Tight or pointy shoes that crowd the toes
• High heels that force pressure onto the front of the foot
• Genetics — some people are more prone to foot problems
• Injuries, arthritis, or nerve issues
• Muscle imbalance or weak foot support

Hammertoes affect women more often than men and are more likely to develop as you age.

Understanding whether your hammertoe is flexible or rigid is the first step to finding the right solution.

Flexible vs. rigid hammertoe

If your hammertoe is flexible, that means you can still move the toe at the joint. You might be able to straighten it with your fingers or by adjusting your foot position. At this stage, the toe hasn’t stiffened, and the joint isn’t stuck in place.

Signs of flexible hammertoe include:

• The toe being bent but still moving
• Mild pain or pressure when wearing shoes
• Corns or calluses forming where the toe rubs your shoe
• Increased pain during activity or at the end of the day

The good news? Flexible hammertoes often respond well to nonsurgical treatments. This is the best time to catch the problem before it worsens.

In contrast, a rigid hammertoe doesn’t move. The joint is fixed in a bent position, and trying to straighten it is painful or doesn’t work at all. This usually means the condition has progressed, and the tissues around the joint have tightened or hardened.

The following are signs of rigid hammertoe:

• The toe is stuck and won’t straighten
• Persistent pain, even when resting
• Corns or ulcers that don’t go away
• Trouble walking or fitting into shoes

At this point, conservative treatments may not be enough, and you might need surgery to correct the problem.

Diagnosing and treating hammertoe

To diagnose hammertoe, we start by learning about your symptoms and examining your foot. We check how flexible your toe is, look for any corns, swelling, or pressure points, and may take X-rays to see what’s going on inside the joint.

Once we know whether your hammertoe is flexible or rigid, we create a treatment plan that fits your lifestyle and goals. 

Treatment for rigid hammertoe typically involves surgical correction. We may remove a small piece of bone, fuse the joint, or use a small implant to straighten the toe.

Most people recover well from hammertoe surgery with proper care and physical therapy, and soon return to comfortable walking and daily activities.

Options for flexible hammertoe include:

Padding and shoe changes

Wearing roomier shoes with soft insoles eases pressure on the toe.

Orthotic inserts

Custom orthotic arch supports help balance the muscles and reduce strain.

Toe exercises

Gentle stretching and strengthening exercises help improve toe movement and slow the condition’s progression.

Splints or taping

These tools help realign the toe temporarily and ease discomfort.

A hammertoe may seem like a minor issue at first, but it can lead to more significant problems if left untreated. The sooner you catch it — especially while it’s still flexible — the better your outcome will be.

Whether your hammertoe is just starting or already causing serious discomfort, we’re here to help you understand your options and feel better on your feet. If you notice a bent or painful toe, schedule a visit to our Mill Creek, Washington, clinic by phone or via the online form.