Hammertoes are toes that are crooked ,typically with the end of the toe pointing down and the first joint sticking up, many times rubbing in the shoe and causing pain. People with painful hammertoes see their podiatrist because the toe is either rubbing on the end of the shoe (typically because the tendon on the bottom of the toe - flexor tendon - is contracted), rubbing on the top of the shoe (extensor tendon is contracted), or is rubbing on another toe causing a painful buildup of thick skin known as a corn. Hammertoes can be flexible or rigid (don't move when you try to bend them). Hammertoes tend to start out flexible and become rigid over time as your toe gets used to being in its crooked position. Hammertoes are thought to result from certain foot types (flat feet and high arched feet) which cause tendons on top (extensors) or on bottom (flexors) to get a pulling advantage over each other causing the toes to be held in a crooked position. A common example of this is when the achilles tendon (tendon on back of leg attaching to the heel bone) is too tight, causing the tendons on top of the foot going to the toes to work too hard, holding the toes in an unnatural elevated position. Your podiatrist will recommend treatment for your hammertoes based on your foot structure which will likely involve removal of any thick painful skin, padding of the painful area and recommendations for shoes that give your curled toes room in the shoe without rubbing. Many times people with hammertoes experience pain on the bottom of the foot, under the ball of the foot, which is where your long bones (metatarsals) end. This comes about as the hammertoes go from flexible to rigid and now hold the toes in an elevated, partially dislocated position ,increasing pressure on the bottom (sole) of the foot. If your hammertoes aren't helped by the conservative care mentioned above, your podiatrist may recommend you undergo a surgical procedure aimed at straightening out the crooked toe. Depending on the severity of your hammertoe, your surgery will either be performed in your podiatrists office or at the hospital. Sometimes a metal pin is used to help the toe maintain its straight position as it is healing.