Big Toe Love

The Back Story

A friend and I met to talk about her foot and the visit to her podiatrist.

She had been previously diagnosed with bone spurs at the place where the big toe meets the foot, the MTPJ, or metatarsophalangeal joint.

Many of us experience or may experience discomfort at this joint due to:

  • bunions and hallux valgus (the big toe is living by the pointer toe)
  • hallux limitus (reduction in normal movement of the big toe)
  • hallux rigidus (literally means “stiff big toe” and is a type of osteoarthritis that is often painful, swollen, and makes us not want to bend that toe)

The bone spurs have made it harder for my friend to bend her big toe without unpleasant sensation.

She is diligent about walking at least 10,000 steps per day, is part of my Longevity Strength group, does Zumba and Jazzercise – she’s a mover.

Recently she began having pain below the second and third toes on the ball of her foot.

The podiatrist suggested she had sprained a ligament and recommended a boot for a week, no bare foot walking, and a very stiff shoe for at least a month.

So hear this… I am not a medical professional.  I did not go to foot doctor school.  And I don’t think her podiatrist is wrong.

I am curious, though. 

Her podiatrist is doing podiatrist kinds of things and that’s great, but one thing that didn’t happen is any talk about function or a movement screen looking at the way she moves the rest of the foot, the ankle, the knee, the hip and above.

Another note is that this sprain in the ligament was only diagnosed through well intentioned and experienced suggestion.  There were no x-rays or MRIs taken.

All I’m suggesting here is that this is a perspective from one lens and through the lens of someone my friend trusts and believes is very good at their job.

I became very inquisitive when we met.

I come from the lens of function so I’m always curious about movement and movement patterns.

My educated guess is that the smaller toes next to the big toe have been taking over the propulsion and balance job of the big toe because it isn’t bending as well as it used to.

That puts the entire body weight of the foot fall and push off when walking or dancing more to the lateral portion of the foot into smaller joints that aren’t the real “push off” levers like the massive strong big toe.

If my friend is not bending that big toe, using it to push off for walking and dancing, then she is using another part of the foot because the body is VERY SMART and figures out a way to adapt to what we ask it to do.

She has definitely been resisting the bend of that big toe because she knows there are bone spurs there and frankly, it hurts when she bends it.

Big Toe Function and Why It Needs to Bend

But here is the thing…. the human big toe is really really really really important not only for walking, but for full body function.

The big toe, or hallux, plays a huge role in balance function for standing and engaging in all kinds of motion.

The big toe is vital for the “push off” or propulsion used to move forward when we walk. 

A large percentage of the control of our entire foot, the function of 26 bones and 33 joints and ligaments that connect them, comes from the flexibility/mobility/strength of the big toe.

The big toe functions to stabilize the long arch of the inner foot, allowing for shock absorption to spread through the entire foot.

Recap:

  • Vital for standing, walking, and activity of daily living functional balance
  • Vital for propulsion – walking, moving forward, running, dancing, moving to hit the pickleball
  • Helps control the entire foot and its function (and its relationship to everything above it)
  • Stabilizes the long arch to allow for shock absorption 
If the big toe doesn’t move, isn’t strong, isn’t mobile, then all of these essential human movements may be compromised and we may start to feel things in other parts of our foot, our ankles, our knees, and even up into our hips, and lower back.

My Suggestions

I suggested that my friend listen to her podiatrist and encouraged her to discuss function with him.

We all should have agency to ask for more information and have further discussions with our health care practitioners.

I suggested my friend explore the several things listed below even if she decided to go the road of less movement, a boot, and stiff shoes:

  • Explore toe spacers for when she wasn’t standing since she was going to be booted.  (I use Wild Toes)
  • Some work with the myofascial ball to help bring awareness to the foot.
  • Manual manipulation of the big toe – a gentle traction of the big toe away from the foot with small slow circles to help create movement and space at the place where the toe and foot meet.
  • Work with an exercise resistance band to encourage strength in the toe extensor muscles (if you look at the top of your foot and lift your toes up you will see tendons bulge up against the skin – try to find the big one that attaches to your big toe because it should be thick and meaty!)
  • Explore a bit of bare foot time if she felt comfortable doing so and it didn’t create any further pain.  Nothing heavy, just a chance to perhaps stand on both feet and allow them to feel her weight bearing.  I wanted to be very careful not to discourage her from following the advice of her podiatrist.
  • Work on balance for intrinsic foot muscle strengthening by walking on a rounded/curved “balance beam”  (intrinsic means the muscles in the foot, not above the foot)

And because I am not a medical professional, I suggested that she ask for specific physical therapy that specializes in foot function.  And to only do the exercises I suggested if she felt comfortable about it and to her own personal tolerance.

Now here’s the really cool thing…

I made a video covering all of this for you.

I uploaded it to youtube and it will live there for your ongoing use.

I encourage everyone, even if you have no foot pain or dysfunction, to work on your feet everyday.

The feet are our foundation and we really need to get to know them better instead of just shoving them in shoes and hoping the shoe does most of the work of providing stabilization and balance.

Now I’ll get off my soapbox and here’s the video: