A normal toe has all its joints – the proximal (PIP) and distal (DIP) interphalangeal joints – lined up in a straight line. In the foot condition known as claw toes, the PIP and/or DIP joints are not lined up perfectly in a 180-degree line; they may be at 30 or 45 degrees or more. This makes the toe appear as if it were a claw or hammer. Hence the name claw toes refers to this condition. Once the muscles of the toes contract – and don’t relax – the DIP and PIP joints take on this shape. If the muscles are contracted for the entire day and don’t relax at night, the tendons and ligaments begin to adapt to the contraction and after time, these tissues ‘forget’ where they are supposed to be. The toe then permanently forms a clawlike appearance, curling downward. Claw toes are considered rigid if the joint is locked and no movement can occur. Claw toes are considered flexible if it can be straightened with your hand. Claw toes cause pain in the toes which can start to alter one’s gait while walking or running. Claw toes could lead to the development of other foot problems such as corns and calluses. Cause Claw toes may be caused by the following: • improper-fitting shoes • muscle imbalance, possibly due to incorrect athletic techniques used in jumping, running or walking • arthritis Treatment & Prevention Many foot problems, including claw toes, can be avoided by examining one’s shoes and discarding the pairs that do not support the foot or do not have a high toe box or wide toe box. Any pair of shoes that crams the toes together is a recipe for causing claw toes, calluses, corns, and bunions. Specific types of splints and crests may be used in the treatment of claw toes. Massaging one’s foot and improving the range of motion of the joints affected is also helpful and can alleviate some of the pain of claw toes. When wearing shoe insoles, consider a ¾ length insole. Surgery is a last resort for this foot issue.