The development of hammer toes is a complex process influenced by various factors, including genetics, foot structure and footwear choices. While flip flops alone may not be the sole cause of hammer toes, their lack of support can contribute to the progression of the condition. Additionally, when walking in flip flops the toes often grip the shoe to keep it in place, straining the muscles, tendons and ligaments in the toes, which may contribute to the development of hammer toes.