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How to Fix Curled Toes: Causes, Treatments, and Tips

how to fix curled toes after stroke

For many years, therapists did not know how to fix curled toes long-term. Instead, they gave patients toe separators and sent them on their way.

These days, we have a better understanding of what causes curled toes, which helps therapists recommend better treatment options.

To help you have an informed conversation with your therapist, here’s everything you should know about fixing curled toes:

Types of Curled Toes

Curled toes are characterized by just that: toes curling under. Your doctor or therapist can look at the toe joints to help diagnose the type of curled toes that you have.

Here are the different types of curled toes:

  • Hammertoe — when the toe bends at the middle joint, which forces the joint upward and the end of the toe downward, resembling a hammer.
  • Mallet toes — when the toes bend down at the joint closest to the tip of the toe.
  • Claw toe — when the 4 smallest toes bend up at the joint closest to the foot, and then each joint thereafter bends down. The toes appear to curl down, and in severe cases, may curl into themselves.

What Causes Toes to Curl Up?

Sometimes curled toes are caused by wearing shoes that are too tight for too long. Other times, curled toes are the result of neurological injury like stroke.

When the neurological impact of stroke impairs the brain’s ability to send motor signals to the toes, the muscles in the foot and toes may over-contract to protect themselves, resulting in curled toes. In this case, it’s a form of spasticity in the feet and toes.

Curled toes can make walking uncomfortable and even painful. Fortunately, there are treatments that can help fix the condition.

Treatment for Curled Toes

Here are some of the best ways to fix curled toes from least-invasive to most-invasive:

1. Rehab Exercises

therapist working with patient to fix curled toes with exercises

Therapeutic exercise for curled toes is the most effective, noninvasive treatment available. It works best when curled toes are the result of neurological injury like stroke.

Curled toe exercises (like the ones we list below) help retrain the brain to properly send signals to the feet and toes. It works by activating neuroplasticity, the brain’s natural ability to rewire itself, through repetition of curled toe exercises.

The more you practice using your toe and foot muscles, the better your brain gets at controlling and relaxing those muscles. When beginning treatment of curled toes, rehab exercises are the best place to start.

Bonus: Download our free Stroke Rehab Exercises ebook. (Link will open a pop-up that will not interrupt your reading.)

2. Botox

Botox is an evidence-based treatment for fixing curled toes after stroke. It helps relieve spasticity by acting as a nerve block, resulting in relaxed muscles, which helps the toes relax. All stroke patients respond differently to Botox. Talk to your therapist to see if you’re a good fit.

3. Electrical Stimulation

When you combine electrical stimulation with other treatments, like curled toe exercises and Botox, you may find even more relief. Electrical stimulation helps stimulate the brain and encourage reconnection between the brain and the toe muscles. This treatment is most effective when curled toes are the result of neurological injury like stroke.

4. Orthotics and Toe Separators

feet with toe separators to help fix curled toes

If you’re currently working with an occupational therapist, (s)he may have already suggested an orthotic with toe crests to help with your curled toes. These orthotics help realign the feet and may help improve pain.

Orthotics are a compensation technique, though. Although it may help improve the condition in the short-term, further neglect of the foot muscles may worsen the condition.

If you’re going to use orthotics – and if your OT recommended it, you should listen to them – be sure to do curled toes exercises also. That way, you’re addressing the root problem as well.

5. Roomy Shoes

If curled toes were caused by wearing shoes that are too tight for too long, then getting shoes with roomier toe boxes can greatly help. This will give the toes necessary “wiggle room.” Also, be sure to avoid high heels as these greatly increase pressure on the toes and may worsen the condition.

6. Surgery

When all else fails, your doctor may recommend surgery to relieve curled toes. Depending on where the problem is, your doctor may recommend snipping some of the tendons to relax the toes. These procedures are invasive, so try to exhaust all your options before considering it.

Exercises for Curled Toes

The best way to fix curled toes is to rewire the brain with rehab exercises.

The following exercises for curled toes below will help — but they may feel weird at first. Some of them require you to curl your toes even more, which you might not want to do.

However, using those muscles is how you will regain control of them.

Here are some simple curled toes exercises to start with:

  • Toe Taps. Attempt to raise all your toes up off the ground and then place them back down. Repeat 10 times. It’s okay if you can’t move your toes very much yet. As long as you attempt to make the movement, you will initiate healing in the brain.
  • Floor Grips. With your feet flat on the floor, attempt to grip the floor by curling your toes, and then release as best you can. Repeat 10 times.
  • Finger Squeezes. Cross your foot over your knee and place a finger in between your big and second toes. Then, squeeze your toes together to pinch your finger as hard as you can (without hurting yourself, of course). Release, and repeat 10 times.
  • Marble pickup. Place a dozen marbles on the floor and attempt to pick them up using your toes. This can be difficult at first, and it’s okay if you need a caregiver to assist you.
  • Towel curls. Place a towel on the floor and use your toes to pinch the towel and pick it up. Then, place it back down, flatten it out, and repeat. This is a difficult exercises, so it’s okay if you don’t get it at first. You will get better with practice.
  • Toe Extensor Strengthening. Cross your foot over your knee so that you’re sitting cross-legged. Then, place a resistance band around the top of your foot to pull your toes back toward your body, like so:

Then, use your foot to push the resistance band away from your body. Return to center and repeat 10 times.

This will be very difficult in the beginning, so remember: as long as you attempt to make the movement, you’re stimulating healing in the brain.

If you need to do these exercises passively with the help of a caregiver, that’s a great place to start.

Tips for Living with Curled Toes

It takes time to rewire the brain with rehab exercises for curled toes, so be patient. As long as you put in the reps, the brain will work hard to reward your hard work!

In the meantime, here are some tips to help you out:

  • Stretch your toes to keep the tendons as lengthened as you can. Avoid this if it’s too painful, but once those tendons shorten, it’s hard to reverse.
  • Try some toe separators when you’re at home. Yes, the cheap foam beauty salon tools that you use to keep your toes separated while manicuring. Using toe separators can help reduce the pain of curled toes.
  • Use toe cushions in your shoes when you’re out and about. Toe cushions are like little pillows for your toes that comfortably go inside your shoes and reduce the pain.
  • Ask your occupational therapist to show you how to use athletic tape. Some OT’s know how to use athletic tape to help align and support curled toes. Ask your OT to see if they can show you how.
  • Get a pair of magnetic gel insoles. A stroke survivor named James claimed that they helped reduce his curled toes. Since it’s a non-invasive treatment, why not give it a shot? You can also cut the gel insoles up to protect your toes from painfully rubbing around in your shoes.

It’s possible that curled toes can go away on their own in time — a phenomenon known as spontaneous recovery.

However, you can take an active role in your recovery by experimenting with these various treatments for curled toes (with your therapists approval, of course).

And there you have it! These are the best ways to fix curled toes.

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See how Susan is recovering from post-stroke paralysis

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I have recently had some movement in my left arm that I did not have before.

I don’t know if I can directly relate this to the use of the FitMi but I am not having occupational therapy so I conclude that it must be benefiting me.

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