Medically reviewed by Dr. Carl Jay, DPM — Board-Certified Podiatrist, Balance Foot & Ankle
⚡ Quick Answer
Toes curl up due to a muscle-tendon imbalance — when the flexor tendons (underneath) overpower the extensor tendons (on top), the toe buckles at the joint. The most common causes are hammertoe (bends at the middle joint), claw toe (bends at both joints), and mallet toe (bends at the end joint). Wearing shoes with a wide, deep toe box and doing daily toe stretches can slow progression. Once the toe becomes rigid, only surgery can straighten it. Early treatment — while the toe is still flexible — gives you the most options.
Looking down at your feet and noticing one or more toes starting to curl upward and bend is alarming, especially when the curl seems to be getting worse over time. The good news: curled toes are one of the most common foot deformities we treat, and in the early stages, conservative treatment can make a significant difference. The key is understanding what type of curling you have, what’s causing it, and — most importantly — catching it while the toe is still flexible.
At Balance Foot & Ankle, we evaluate and treat curled toes daily at both our Howell and Bloomfield Hills offices. This guide covers the different types of toe curling, their causes, and the full range of treatment options from simple stretches to minimally invasive correction.
Types of Curled Toes
| Type | Which Joint Bends | Appearance | Most Common Toes |
|---|---|---|---|
| Hammertoe | Middle joint (PIP) bends downward | Toe tip points down, middle bows up | 2nd toe (most common) |
| Claw toe | Both joints (MTP and PIP) bend | Toe curls into a claw shape, tip digs into sole | Multiple toes (2nd–5th) |
| Mallet toe | End joint (DIP) bends downward | Only the tip drops down | 2nd or 3rd toe |
| Curly toe (pediatric) | Toe rotates and tucks under neighbor | Toe spirals beneath adjacent toe | 3rd, 4th, or 5th toe in children |
What Causes Toes to Curl?
Muscle-tendon imbalance (most common): The muscles that flex (curl) the toes and the muscles that extend (straighten) them work in balance. When the flexors become dominant — from years of wearing shoes that scrunch the toes, from weakness in the small intrinsic foot muscles, or from neurological conditions — the toes gradually curl.
Shoe shape: Narrow, pointed toe boxes force toes into a curled position for hours daily. Over years, the tendons shorten and the toe becomes fixed in the bent position. High heels compound the problem by shifting body weight onto the ball of the foot, pushing toes against the front of the shoe.
Bunion: As the big toe angles inward (hallux valgus), it crowds the 2nd toe, which has nowhere to go but up — creating a secondary hammertoe. Correcting the hammertoe without addressing the bunion often leads to recurrence.
Neurological conditions: Peripheral neuropathy (from diabetes, alcohol, or other causes), Charcot-Marie-Tooth disease, and stroke can weaken the intrinsic foot muscles that keep toes straight, leading to progressive toe curling. If all toes on both feet are curling, a neurological workup should be considered.
Trauma: A previous toe fracture, dislocation, or tendon injury can lead to scar tissue formation and imbalanced healing that results in a curled toe.
Arthritis: Rheumatoid arthritis and osteoarthritis can destroy the small joints in the toes, leading to progressive deformity and curling.
The Flexible vs. Rigid Test
This is the most important assessment for determining your treatment options. Sit down, grab the curled toe, and try to straighten it manually.
If the toe straightens easily: It’s a flexible deformity. The tendons haven’t permanently shortened yet, and conservative treatment (stretches, toe spacers, shoe changes) can slow or halt progression. This is the ideal time to intervene — don’t wait until it becomes rigid.
If the toe won’t straighten: It’s a rigid deformity. The tendons and joint capsule have permanently contracted. Conservative measures can reduce symptoms (pain, corn formation) but cannot straighten the toe. Surgical correction is the only way to permanently fix a rigid curled toe.
Treatment Options
Conservative Treatment (for Flexible Deformities)
Toe exercises: Daily toe curls, marble pickups, and towel scrunches strengthen the intrinsic muscles that keep toes straight. Also practice actively spreading and extending your toes for 10 repetitions, 3 times daily. These exercises can’t reverse a rigid deformity but can slow or halt progression of flexible ones.
Toe spacers and separators: Silicone toe spacers worn during the day help maintain proper toe alignment and counteract the crowding from shoes. Correct Toes are our top recommendation — they can be worn inside wide shoes.
Wide, deep toe box shoes: The single most important footwear change. Your shoes should have enough vertical and horizontal space in the toe box that toes can lie flat without being compressed. Hoka Bondi and New Balance 990 series both offer generous toe box dimensions.
Custom orthotics: For curled toes caused by biomechanical issues (flat feet, overpronation), custom orthotics address the root cause by improving foot mechanics and reducing abnormal forces on the toes.
Padding: For corns on top of buckled toes, gel toe caps or donut-shaped pads reduce friction and pain. These treat the symptom (corn) while other measures address the deformity.
Surgical Treatment (for Rigid Deformities)
When toes are rigidly curled and causing persistent pain, corns, or difficulty wearing shoes, surgical correction is highly effective. Modern minimally invasive techniques allow many hammertoe corrections to be done through small incisions with faster recovery.
Arthroplasty: Removing a small portion of bone at the bent joint to allow the toe to straighten. Most common for flexible-to-semi-rigid deformities.
Arthrodesis (fusion): Fusing the bent joint in a straight position using a small pin or implant. Best for rigid deformities. The toe loses bending motion at that joint but lies flat and straight.
Tendon transfer: Rerouting a tendon to rebalance the forces on the toe. Often combined with other procedures for comprehensive correction.
Recovery from hammertoe surgery typically takes 4–6 weeks, with most patients walking in a surgical shoe the same day. Full return to regular footwear is usually 6–8 weeks.
Products We Recommend
🏆 #1 Pick: Correct Toes Toe Spacers
Medical-grade silicone toe spacers designed to be worn inside wide shoes throughout the day. They gently realign toes toward their natural position, slowing hammertoe progression and reducing pressure between toes.
Also Recommended: Hoka Bondi 8
Wide, deep toe box gives curled toes room to lie naturally without compression. The rocker sole reduces push-off forces that aggravate hammertoe symptoms.
Also Recommended: PowerStep Pinnacle Orthotics
Arch support corrects overpronation that contributes to hammertoe development by reducing abnormal forefoot loading.
Disclosure: Product links are affiliate links. We may earn a small commission at no cost to you. We only recommend products we use or trust clinically.
Frequently Asked Questions
Can curled toes be straightened without surgery?
Yes, if the deformity is still flexible (you can manually straighten the toe). Conservative treatments including toe exercises, spacers, taping, and proper shoes can slow or halt progression and improve alignment. However, once a curled toe becomes rigid (you can’t manually straighten it), surgery is the only way to permanently correct the position. Early intervention is key.
Is it normal for toes to curl with age?
Toe curling is common with aging but it’s not inevitable. The intrinsic foot muscles weaken over time, fat pads thin, and decades of narrow shoe wear can shorten toe tendons. While it’s common, it shouldn’t be ignored — progressive curling leads to corns, pain, balance problems, and difficulty wearing shoes. Simple daily exercises and proper footwear can significantly slow age-related toe curling.
Why do my toes cramp and curl up at night?
Nocturnal toe cramping and curling is usually caused by muscle fatigue (from being on your feet all day), dehydration, electrolyte imbalances (low magnesium, potassium, or calcium), or peripheral neuropathy. If cramping is frequent, try stretching your toes before bed, staying well-hydrated, and ensuring adequate magnesium intake. If cramping persists, it’s worth having your electrolyte levels and nerve function checked.
Does hammertoe surgery hurt?
The surgery itself is painless — it’s performed under local anesthesia or with sedation. Post-operative discomfort is typically mild to moderate for the first 2–3 days, well-controlled with prescribed pain medication and elevation. Most patients describe it as “much less painful than expected.” By day 3–5, most patients only need over-the-counter pain relief. You’ll walk in a surgical shoe from day one.
The Bottom Line
Curled toes are progressive — they get worse over time, never better on their own. The most important thing you can do is act while the toe is still flexible, when conservative treatments (toe exercises, spacers, and wide shoes) can make the biggest difference. If your toes are already rigid, surgery is highly effective and recovery is straightforward. Either way, a podiatrist can assess your specific situation and recommend the right approach during a single office visit.
Sources
Coughlin MJ, et al. Hammertoe deformity. Foot Ankle Clin. 2011;16(4):547-560. | Schrier JC, et al. Treatment of hammer toe deformity: a systematic review. Foot Ankle Surg. 2009;15(2):67-70.
Toes Starting to Curl? Don’t Wait.
Early treatment gives you the most options. Our podiatrists can assess whether your curled toes are still flexible and recommend the right treatment plan. Two convenient locations in Howell and Bloomfield Hills.
Dr. Tom Biernacki, DPM is a board-qualified podiatrist and foot & ankle surgeon serving Southeast Michigan at Balance Foot & Ankle Specialists. A Michigan native, Dr. Biernacki earned his undergraduate degree from Michigan State University and his Doctor of Podiatric Medicine (DPM) from Kent State University College of Podiatric Medicine. He completed a three-year comprehensive surgical residency in foot and ankle surgery in the Detroit metro area.
Dr. Biernacki specializes in the treatment of heel pain, bunions, hammertoes, diabetic foot care, sports injuries, flatfoot correction, and minimally invasive foot surgery. He is dedicated to providing evidence-based, patient-centered care that helps people of all ages stay active and pain-free.
He sees patients at multiple convenient Metro Detroit locations and is committed to community education through the MichiganFootDoctors.com resource library. Dr. Biernacki is a member of the American Podiatric Medical Association (APMA) and the Michigan Podiatric Medical Association (MPMA).