You probably do not think about your toes as you go about your daily activities, yet you rely on them to provide balance, support, and propulsion.

Toes are incredibly complex for being such a small body part. Distributed amongst your ten toes are 28 bones, and even more muscles, tendons, and ligaments, all working in unison to keep you moving comfortably.

For various reasons, this delicate and complex functional unit makes toes prone to deformities and misalignments over time. When this occurs, the toes may become painful and may even restrict your mobility.

Never make light of or neglect a toe deformity. Even if the deformity is without symptoms, the one thing toe deformities have in common is that they usually get worse—much worse—if left untreated.


Bunions are probably the most common and well-known example of a toe deformity.

The most obvious external sign of a bunion is the large bump that forms along the inside of your foot at the base of the large toe. As this deformity progresses, the large toe (hallux) drifts towards the second toe and creates a malalignment. This may ultimately result in the hallux underlapping the second toe.

Without treatment, bunions will typically become more pronounced, arthritic, and painful. As the deformity progresses, it becomes difficult to wear normal shoes, walk long distances, or participate in other athletic activities.

Please read our service page on bunions for a more in-depth look at this condition, as well as the treatment options.

Hallux Rigidus

Hallux rigidus is commonly known as a “dorsal bunion,” because the bump that forms at the base of the large toe is on the top of the foot instead of the inside. This is an arthritic condition that results from the impingement or jamming of the big toe joint during activity.

In the infancy of this deformity, you will notice a soreness at the base of the large toe after extended walking or standing in poorly supportive shoes, bare feet or flip flops. As this condition progresses, you will notice a bump or enlargement on the top of the joint, decreased motion, and increased pain with less activity.

Unlike a traditional bunion, the big toe will not drift towards the second toe.


If you feel a lump or marble beneath the ball of your foot while walking barefoot on hard floors, or notice swelling and/or instability at the base of your second or third toe, you may have capsulitis.

The bone at the base of each toe (phalanx) is connected to a metatarsal (forefoot bone) with several ligaments and tendons, which creates a “capsule” designed to surround and stabilize that joint. Unfortunately, these ligaments may become inflamed, weakened, or damaged from overuse and/or trauma, compromising their ability to hold the toe in place.

Early on, you may notice pain, swelling, and discomfort in the ball of the foot, especially when walking barefoot. As this condition progresses, the toe will become unstable, drift out of alignment, and may eventually cross over neighboring toes.


A hammertoe is the result of a toe getting “stuck” in a bent position with the middle joint arched up and the tip of the toe pointed downward.

In early-stage hammertoes, the raised joint is relatively flexible, easily extended and straightened when held in place with your fingers. If left untreated, the bent joint will slowly become more rigid and arthritic, making it difficult to walk comfortably.

The stiff contracted shape of the toe may develop painful corns on the top of the bent knuckle or the tip of the toe where the pressure of the shoe rubs against them.

Hammertoes can develop in any of the four smaller toes, but like capsulitis, it is especially common in the second toe.

Please read our service page on hammertoes for a more in-depth look at his condition, as well as the treatment options.

Common Causes of Toe Deformities

The precise underlying cause of any given deformity will be dependent upon the deformity itself, as well as your own personal circumstances.

The one thing true of all toe deformities is that there is usually an underlying structural or genetic component at work. In other words, the feet you inherited may be more susceptible to certain deformities because of their shape and the way they function.

For example, a flexible foot is prone to developing bunions, capsulitis, and hallux rigidus (arthritis of the large toe joint). A Morton’s foot (second toe longer than the first) tends to develop hammertoes and capsulitis. A high arch (cavus foot) is inclined towards hammertoe formation. Sometimes simply having one toe deformity can lead to another.

Ill-fitting shoe gear, repetitive injuries, and other external factors may also be involved. At the very least, these factors can aggravate your symptoms and accelerate the progression of the deformity.

At your appointment, Dr. Thomas J. Bobrowski will perform a thorough examination, review your past medical history, and question you about your condition to determine the specific underlying cause. All this information allows us to put together a comprehensive treatment plan most effective and appropriate for you.

General Treatment Approaches for Toe Deformities

The recommended treatment plan is dependent upon the specific deformity, the etiology (underlying cause), and the severity of the condition.

However, regardless of the circumstances, our initial preference is to treat your deformity conservatively if possible, using shoe modifications, orthotics, physical therapy, or splinting.

Non-surgical treatments, regrettably, will not realign the affected toes, but they will often alleviate your pain and slow the progression of the deformity.

Surgical correction of the deformity is considered if pain is affecting your daily quality of life and/or preventing you from participating in the activities you especially enjoy.

So, please do not wait until your toe deformities are rigid and severely painful before making an appointment with our office. You can reach InStride Crystal Coast Podiatry at (252) 638-4700 or fill out our online appointment request form.