Do tight shoes cause hammertoes?

I am often asked this question, and see it improperly discussed online and even by medical professionals.  The simple answer is that tight shoes are not the cause of hammertoes, despite popular belief.  Hammertoes, which is a term often used to describe a plethora of conditions in which the toes curl up or rotate, have numerous causes that usually start with abnormal foot structure and imbalance between muscles that pull the toe up and those that pull the toe down.  This imbalance, caused by abnormal muscle pulling that develops from having feet that are structurally closer to extremes of being flat or high arched, forces the toes to curl downward in various ways.  Shoes do not influence the position of the toes and cannot ‘force’ the toes downward, although poorly fitting shoes can irritate the skin and joints of toes made more prominent by the curling.