A claw toe is a toe that is contracted at the middle and end joints in the toe. This position can lead to severe pressure and pain. Ligaments and tendons that have tightened cause the toe’s joints to curl downwards. Claw toes may occur in any toe. There is often discomfort at the top part of the toe that is rubbing against the shoe and at the end of the toe that is pressed against the bottom of the shoe.
Claw toes are classified based on the mobility of the toe joints. There are two types – flexible and rigid. In a flexible claw toe, the joint has the ability to move. This type of claw toe can be straightened manually.
A rigid claw toe does not have the ability to move. There is limited movement if any and it can be extremely painful. This sometimes causes foot movement to become restricted leading to extra stress at the ball-of-the-foot, and possibly causing pain and the development of corns and calluses in that particular area due to friction and pressure.
Claw toes result from a muscle imbalance which causes the ligaments and tendons to become unnaturally tight. This results in the joints curling downwards. Arthritis can also lead to many different forefoot deformities, including claw toes. The diagram below demonstrates the anatomy of a claw toe. Callus can form at the bottom of the joint from thickening of the skin due to friction while corns can develop of the top of the toes due to pressure and friction.
Changing footwear is a very important step in the treatment of claw toes. When choosing a shoe, make sure the toe box (toe area) can accommodate the foot. The toe box must be high and broad. A shoe with a high, broad toe box will provide enough room in the forefoot area so that there is less friction against the toes.
Other conservative treatments include using forefoot products designed to relieve claw toes, such as toe props, elevators and toe splints. These devices will help hold down the claw toe and provide relief to the forefoot. Gel toe shields and gel toe caps are also recommended to eliminate friction between the shoe and the toe, while providing comfort and lubrication.