If one set of tendons overpowers the other or is used excessively due to an imbalance, the result is excessive bending of the toe. Over time this can lead to tightening of the tendon and later, contracture of the toe. If the bent position of the toe can still be manually straightened out, the deformity is called a flexible hammer toe. When the contracture cannot be manually straightened out it is called a rigid hammer toe. When both joints are contracted the deformity is called a claw toe.
Early treatment is directed at reducing the pressure on the contracted toe.
As the corn thickens it produces irritation in the underlying tissue which becomes swollen and painful. Early treatment is directed at reducing the pressure on the contracted toe. This can be achieved by use of a lower heel height, deeper toe box shoe or sneaker, shaving down the corn, or accommodative padding. Sometimes functional orthotics may help the foot work more efficiently and reduce the imbalance of tendons, lessening the tendency toward hammer toe contracture. When conservative care does not relive a painful deformity, surgery is recommended.