Curly toes, otherwise known as clinodactyly, describes when some of the toes curl inwards when a child is standing. Curly toes often affects the third, fourth and fifth toes, and the shape is usually present from birth, becoming more noticeable as your child begins walking.
What causes curly toes?
We all have tendons that run beneath our foot and attach to our toes, supporting the healthy function of the foot. Curly toes develop because the tendons that run beneath the toes pull on the toes so that they curl downwards and may rotate inwards. This condition appears to run in families, as it often presents in several generations.
If you notice your child’s toes start to curl with prominent bumps at the joints, they may have hammertoes or claw toes. These usually occur from changes to the joints in the toes and may occur as a result of pressure from tight footwear.
What are the symptoms?
Often, curly toes will not cause any painful symptoms, just the visible curling of the toes. Sometimes, curly toes may cause discomfort and changes to the skin or nails, like corns, callus, blisters, thickening or distortion to the shape and appearance of the nail. The changes may make it difficult to wear some types of footwear.
How are curly toes treated?
If your child is not experiencing any symptoms, treatment is typically not indicated. You can help by choosing shoes for your child that have a wide toe-box, so that nothing is pushing against the ends of the toes. Up to the age of five, toes may also change shape significantly. Studies have shown that 25% of curly toes may resolve on their own 
If your child is experiencing pain or other symptoms, bring them in to see us. We’ll perform an assessment to understand the best ways to relieve the painful symptoms and implement strategies to reduce the likelihood of them from coming back. We always look at non-surgical treatment options first, like stretching and toe-props.
In very rare cases, we may refer you to an orthopaedic surgeon for an assessment.
1 – Sweetham R. Congenital curly toes: An investigation into the value of treatment. Lancet 1958; 2(7043): 398-400.