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  • Dr. Brian Abelson DC.

Toes are Important - Especially Your Big Toe

Updated: Jun 30


You have a lot of bones in your toes (or phalanges), actually 14 of them in each foot. Though they are all important, the bones of your big toe (called the hallux) is especially important. The big toe plays a critical role in both shock absorption and propulsion.


When you walk or run, the big toe plays an essential role in arch stabilization during mid-stance, and during the take-off phase of the Normal Gait Cycle. Without this stabilization, the foot would have limited, to no, shock absorption capability, and very limited propulsive force. Big to function is important!


In order for this stabilization to occur effectively, the big toe must be properly aligned with its surrounding and supporting structures (both joints and soft tissue). This requires both good joint mobility as well as a balanced synchronization of action with the structures that attach to the big toe (muscles). Without this, key muscles such as the flexor hallucis longus and flexor hallucis brevis muscles will not be able to stabilize the foot. Abnormal foot pronation, a common condition faced by many people, is a great example of this problem.


So why does increased pronation (abnormal pronation) affect big toe function?

  • Along the underside of the big toe are two sesamoid bones. These are floating bones that are embedded into the tendons that surround the big toe. These sesamoid bones slide around with each change in position of the big toe.

  • When the big toe is in its ideal position, these sesamoid bones slide into two grooves (within the first metatarsal), giving them the ideal position for providing foot stability.

  • When the big toe is misaligned (as in cases of prolonged abnormal pronation), these sesamoid bones slide towards the inside of the big toe into a position where the attaching muscles (flexor hallucis) cannot provide the required stability

It’s easy to see how a simple misalignment of the big toe (due to abnormal pronation) can cause a decrease in foot stability.



EXERCISES


There are several exercises that you can perform to improve “Big Toe Joint” Mobility. Besides working on the joint inself, it is important to work on the mobility of the soft tissue structures that attach to the big toe. Some these structures, such as the Flexor Hallucis Longus (FHL) muscle originate under your calf muscles (much farther up the kinetic chain). This is why I provide you exercises that are not just for the foot, but trust me, these other structures greatly affect foot function.


Strengthening exercises are another critical component for maintaining Big Toe function. Focusing on only mobility exercises will only deliver short term results.


Caution: If you are suffering from a foot condition, please see a qualified medical practitioners for help.These exercise recommendations are only for individuals who would like to improve their overall function, not resolve a condtion.



MOBILITY:

The following mobility/flexibility exercises can be performed every day, even several times per day.


Increasing Big Toe Mobility - Self Mobilization - MSR: Having mobility in the joints of the big toe is essential for normal gait. However, the joints of the big toe (MTP and DIP) are common sites of restriction. In addition the most common site of arthritis in the foot is at the base of the big toe. Be sure to go slow with this exercise for maximum results.




Foundational Self Myofascial Foot Release: Great Exercise for Plantar Fasciitis, Bunions, and most foot conditions. This video goes over the logic of doing a myofascial release of the foot. Then it shows you how to release the structures under your foot using a lacrosse ball in combination with some pin and stretch techniques.



Stretching Your Calf Muscles: This video provides you with stretches for both your calf muscles the gastrocnemius and soleus. Only minor changes in technique can make a huge difference in increasing your calf flexibility.






Myofascial Release of the Shins: Some of the muscles on your shins, such as the Tibialis Anterior, connect into the big toe. This video covers several ways to release myofascial restrictions in your shin muscles using foam rollers, and a tiger tail or rolling pin.







STRENGTHENING:

The strengthening exercises can be performed every other day.



Great Bunion Exercise - Strengthening the Feet: We have found the following exercises to be very effective in addressing Bunions. This is just one exercise we would prescribe to patients with bunions. This exercise would be combined with several myofascial release exercises. Also a great exercise to help stabilize gait patterns caused by big toe dysfunction.



Foot & Ankle Strengthening Routine - Using a Theraband (Follow Along Video): This foot and ankle strengthening routine works the flexors, extensors, internal and external foot rotators using a Theraband.






Calf Strengthening - Eccentric Calf Raises & Pulsations: The Eccentric Calf Raise is a great way to increase calf strength, without causing further injuries. These dynamic calf-pulsations are ideal exercises for improving sports performance and power. This is an advanced exercise, so before attempting this exercise, make sure you can easily perform the standard Eccentric Calf Raises & Pulsations.


Your calf muscles provide the power to push off (plantar flex) with your foot during walking and running. Weak calf muscles will cause several alterations in gait patterns that could lead to conditions such as Plantar Fasciitis.


WHEN EXERCISE IS NOT ENOUGH

Sometimes you need some help in releasing the restrictions you are experiencing in your big toe (or other joints) and the soft tissues of your feet. Manual therapy is a great way to release those restrictions. Below are two example of MSR procedures that we have found very effective in releasing those restrictions. In the first video address joint restrictions in the second soft tissue restrictions.


Caution: These videos are for demonstration purposes only, and are not recommendations for a specific case. MSR procedures should only be performed by qualified and licensed manual practitioners.



7 Point Ankle & Foot Mobilization - MSR: Improving joint mobility is critical if you are going to effectively address the body's full kinetic chain. In fact, we greatly reduce the effectiveness of any myofascial treatment if we don’t also address restrictions in joint mobility. The objective of joint mobilization is to reverse adverse physiological changes by promoting movement between capsular fibers. (This video will be available June 24/2020)


Plantar Fasciitis - Manual Foot Procedures: Even though this video is directed toward Plantar Fasciitis procedures, you will still be able to see procedures that we commonly use on soft tissue structures that connect into the big toe. (This video will be available May 20/2020)





DR. BRIAN ABELSON DC.

Dr. Abelson believes in running an Evidence Based Practice (EBP). EBP's strive to adhere to the best research evidence available, while combining their clinical expertise with the specific values of each patient.

Dr. Abelson is the developer of Motion Specific Release (MSR) Treatment Systems. His clinical practice in is located in Calgary, Alberta (Kinetic Health). He has recently authored his 10th publications which will be available later this year.

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