A hammer toe is a toe with an abnormal bend in the middle joint, caused by foot instability, a flat or high arch, arthritis or footwear which has been worn too tight or too short. The main causes for concern with footwear is to have a vamp which is deep enough over the toes to not rub the skin, or the footwear to be deeper over the toes. The ball of the foot may also feel painful as the hammer toe pushes the metatarsal joint down. Use a soft shoe insert with some arch support and always wear shoes with cushion soles. If you have a higher risk foot, for example if you have diabetes, then be particularly careful with your shoe fitting.