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How The BIG TOE Influences Your Stability And Movement

Written by: Nick Jack
Category: 2014
on 24 January 2019
Hits: 10243

The big toe is a very underestimated joint in providing us with the stability and strength for movement. I would be the first to tell you that I was ignorant to this for a very long time, even considering I know exactly what happens if you injure your big toe as I have broken mine before. It left me on crutches for several weeks and unable to walk or run correctly for months. It was not this however that led me to appreciate foot stability a lot more, it was more to do with my frustration at not being able to help some people with walking difficulty. Back in 2015 we started working with several tricky cases of people who had severe walking impairments from car accidents, disease and spinal injury. Working closely with these clients several times per week our typical training was helping a lot but not providing the improvement we really wanted. I knew we were missing something and I could see that in every case there was huge problems at the feet, even though none of these people had pain at the feet. We have covered the role of Foot Stability before but today I want to share more insight into the big toe for as you will soon see there is a correlation between big toe dysfunction and injury elsewhere in the body.

How The Big Toe Creates Problems For Other Joints

For over 15 years we have dedicated our training to helping people recover from injury and health problems. We have also worked with many elite sporting athletes searching for improved performance. In both cases we are trying to improve the same thing - their ability to move more efficiently. The first group to get out of pain, and the other to achieve sporting success. Over the past 5 years here is a list of the most common injuries we have seen.

  • Bulging disc - 26
  • ACL tear or rupture - 13
  • Hip pain/piriformis syndrome - 19
  • Knee pain - 17
  • Shoulder pain - 13
  • Foot pain - 5

(This is just the list of local clients we see, and does not include the statistics of our online injury rehabilitation programs where we have seen over 1000 downloads in the past year).

The most interesting thing I see with this list is the small number of foot related injuries in comparison to the other injuries. Yet when we complete our assessments, and especially with knee and hip related injuries, it is extremely common for us to find huge stability problems at the feet. The big toe in particular, being rigid and unable to lift. Most of the people we asses indicate they have no pain at the foot, ankle, or any problems with the big toe. When we went back and analyzed the results of these assessments the findings were compelling.

We found that in over 70% of people assessed for knee pain or hip pain there was significant foot instability and big toe dysfunction! This information really begins to explain a great deal about how people easily compensates at other joints due to problems at the foot. And how any corrective exercise intervention may have limited success if the source of the problem, which in this case is the big toe and foot instability is not addressed. I decided I needed to see if these findings were consistent with other highly respected practitioners and more experienced people.

I started to read several books that talked a lot about the importance of the feet, (the 3 books below are great reading) and I also completed several courses both in person and online.

I also began training myself, testing various drills and exercises on my own body and with the other trainers to understand the information we had learned. We implemented the Sensa Mat which was a huge revelation in terms of our training with foot stability and was a instantly a massive success.

See our article - Improve foot stability using the Sensa Mat

During the time we were testing more people I started to see a very common trend emerge among ALL people that had lower limb or hip/back injuries, and it was dysfunction of the big toe. The big toe dysfunction I am referring to is where there is a lack of dorsiflexion, (lifting the big toe backwards to your shin). Over 95% of people we tested had NO PAIN at the big toe or had ever been diagnosed as even having anything wrong.

In all the books and the information we had seen the best explanation as to how this small joint creates massive problems was in the book "Movement" by Gray Cook.

How Does Your Toe Have Anything To Do With Pain In Your Knee Or Hip?

This is the first thing people think when I tell them to take their shoes and socks off so I can assess their toes and feet. If you have never read or heard us talk about the joint by joint theory developed by Gray Cook and Mike Boyle you will quickly see why this is so important. Every second joint in our body needs a completely different role to the joint above or below. Any time a joint loses either it's stability or mobility the joint above or below is greatly affected and forced into compensation.

The entire joint by joint list is below.

  • Big Toe: Needs Mobility
  • Mid-Foot: Needs Stability
  • Ankle: Needs Mobility
  • Knee: Needs Stability
  • Hip: Needs Mobility
  • Lumbar Spine: Needs Stability
  • Thoracic Spine: Needs Mobility
  • Cervical Spine (lower): Needs Stability
  • Cervical Spine (upper): Needs Mobility
  • Shoulder: Needs Mobility
  • Elbow: Needs Stability
  • Wrist: Needs Mobility

Now the one joint that has a significant bigger role than all of the others is the big toe. Do you remember how I said that if there is a problem at a particular joint like the hips it will compensate to the joints above at the lumbar spine and below at the knee. In the case of the big toe it has not joint below to refer to, so it is forced to compensate only above. The big problem here is that when we walk or do anything standing this joint is the first thing to move and as it has to compensate due to rigidity and lack of movement it begins to set off a chain reaction to ALL of your other joints. It is now just a matter of time until you are in trouble.

I hope you are beginning to see the potential problems that can arise from something so simple as a lack of big toe mobility, and just how easily it can lead to a wide spread of problems not just at the foot but right up the kinetic chain and beyond. Examples of this compensatory chain reaction in action is when we observe poor knee alignment in single leg stance that causes pain and injury to the knee. Strengthening of muscles around the knee is pointless for the knee is dragged into the poor alignment by the weak foot and stiff ankle compensating. Until the cause of the problem is addressed no treatment will respond effectively.

You can see more detail on this in the article - Why The Knee Is Not The Problem For Knee Pain

How Does The Big Toe Lose Mobility In The First Place?

That is a great question and it can be due to several things, but without doubt the most obvious reason is footwear. Most shoes place us in elevated heels and create short tight calves with rigid ankles and weaken our feet. High heels cause serious problems, as do flip flops (thongs as they are known in Australia) as they completely change our gait cycle and require “toe gripping” to keep them on while you walk. If we were to walk barefoot as nature intended you would find that our entire body would be so more robust and strong.

Other factors that contribute to the problem

  • Lack of exercise & sitting too much
  • Poor running form or training technique
  • Fatigue
  • Previous injury

Another great book I highly suggest to read is "Born To Run" by Christopher McDougall shows an example of exactly this in action.

This is a story of a guy who loved running but suffered with chronic injuries for a long time even with all the latest shoes, rehabilitation and treatment modern science provides. He set about researching the secrets of a hidden tribe in the desert that ran barefoot for hundreds of miles and never had an injuries! When running barefoot, over striding and heel striking are not an option you will do for very long. The impact is immense and produces jarring and instant pain right up your entire leg. A bit like removing the suspension from you car. The modern running shoe with all the extra cushioning allows people to run without changing this faulty movement and while it saves you in the short term, over the long term running with this faulty technique will only serve to put you in pain. Not always at the feet, but where the shock runs to which is the joints above in the leg.

At first I thought we could overcome this by training the weak feet using the sensa mat and staying barefoot all the time. And while this was a great start, and definitely helped, in some cases we needed much more, and paying close attention to the big toe was the key. But first I needed to learn more about the big toe and exactly what it does and how much movement it required.

Big Toe Anatomy & Function

The way the foot muscles and array of small joints is designed allows the big toe to plantar flex during extension phase of walking to enhance the load-bearing capacity of the first metatarsal, and to improve the mechanical leverage for the attached intrinsic muscles. It has been documented that the first ray is designed for 50-70 degrees of big toe extension during static evaluation.

As the foot transitions from mid stance into push-off, the toes begin to dorsiflex and the plantar fascia is activated. This activation of the plantar fascia upon big toe dorsiflexion is referred to as the “windlass mechanism” and is the second step in preparing the foot for propulsion.

Since power during propulsion is dependent upon the foot’s ability to become a rigid lever, ensuring proper big toe dorsiflexion during the gait is vital to achieving full foot supination. When you understand that during gait, your entire body is moving over this single joint, the ability to dorsiflex, and subsequently raise the heel during single support phase while simultaneously supporting against the developing forces for forward motion is essential for normal, efficient walking.



If this mechanism fails, your body will be forced to compensate. When the big toe joint motion is disrupted enough to prevent stabilization of the foot you are now set up for problems up the entire chain.

A common postural problem seen with big toe dysfunction the gradual shift into a forward weight bearing position. This forward leaning position creates the recipe for a permanent change in how we move or simply hold ourselves up in an upright position. For the brain will begin to learn from repetition that this is the new way to move.

Our brain does not question if this is a mechanically advantageous or not, it will continue to compensate in order to move and execute the tasks at hand. This is why it is so important to always train with good technique and find ways to ensure you are adopting the most efficient method of movement. The key is not allowing compensatory patterns to become encoded into the nervous system as permanent movement patterns.

See our article -  Functional Movement Is Everything for more details on the 7 key patterns of movement.

Common Problems Linked To Big Toe Dysfunction

One thing is for certain it is very difficult to correct a faulty gait pattern once dysfunction sets in. It is so much easier to be aware of the potential dangers of compensation and using exercises to enhance your ability to walk and run correctly BEFORE they are broken down. Watch the video below for ideas on this.

Some of the most common compensations seen are instability in the midfoot, poor ankle mobility, and limited hip extension.

  1. Limited proprioception in the midfoot usually leads to plantar fascitis or achilles strains.
  2. Lack of ankle mobility is a very common problem we see with knee pain. When we walk we need at least 10 degrees of ankle dorsiflexion with maximum ankle dorsiflexion occurring during late mid-stance. Limited ankle mobility can lead to a chain reaction of compensations including midfoot pronation, knee hyper-extension and an early heel rise during gait. See article - How Poor Ankle Mobility Causes Destruction To Your Knee
  3. Limited hip extension can lead to abduction compensation and produce the classic over pronated foot type and abducted stance position. The stride length shortens and reduces hip extension and glute activation. You can see how hip problems like piriformis syndrome that exhibit glute weakness and inhibition could be driven by problems at the big toe and feet! When the correct pathway of motion is blocked by the lack of big toe dorsiflexion, the person will produce an abducted foot in order to roll off the inside of the toe in order to allow for hip extension.

This compensation is most often related to the development of bunions.

But even worse than this, there is also a lot of research indicating big toe dysfunction is a predictor of ACL injuries in sports for it places the knee in the point of "no return" as seen in the picture on the left below. The plant foot angle used with change of direction movements in sports is critical to get right for it provides the optimal base for braking and instantly changing to acceleration during the push-off movement. If the foot plant is correct, this split second movement is smooth and effortless. If not the risk of ACL ruptures and various other knee and hip injuries is increased.

Read this article for more detail and specific exercise drills to teach this skill. 5 Critical Things You Need Before Returning To Sport After ACL Surgery

A great quote that really sticks in my mind and really sums up the role of the foot is by Dr Emily Splichal.

"The ability to rapidly unlock and lock the foot is necessary for peak performance - especially in sports or movements that demand rapid change acceleration of change of direction". 

What Can You Do To Improve Your Big Toe Function?

Well the good news is there is many things you can do and they are actually fairly easy. One of the first things I suggest you do is get some toe spreaders! I myself have been using them everyday for some time now and my feet feel amazing! Wearing them as often as I can at home for hours at a time, I quickly see my toes begin to develop better alignment and my foot muscles that had become a bit lazy working better than ever! You can get some of these by visiting the website Foot Collective

You can also practice spreading your toes using your foot muscles. This is a great way to reprogram the stability at the feet and it is incredible how many people find this so difficult to do. Use your fingers to help you if need be sure you can easily spread your toes apart.

Big Toe Lifts

You could think of this as bicep curls for your toes. Stand with your feet pelvis width apart and pointing straight ahead with your weight in your heels. Try to lift the big toe only without moving any other part of your body. I often see people try to move their hips to help out which again is another clue as to how the body will compensate and this is where hip problems are created. Make sure you lift your toe straight up and not let it veer sideways. One you can do this then practice lifting all the toes except the big toe! And if you can do that then practice lifting one toe at a time and placing it back down slowly.

You can see exactly how to do this and also several other exercises we use with feet in the video below.

 

Learn How To Move Correctly

Lastly I would incorporate training bare feet into your gym sessions if possible. Teaching your body how to correctly stabilize the feet in combination with the other joints and muscles in work will go a long way to preventing any compensation or dysfunction that may already exist. Using movements like lunges and step ups that demand full flexion and extension of the big toe are fantastic, as are any of the single leg exercises that require full foot stability in order to maintain alignment of the kinetic chain.

See videos below. The video on the right with the Sensa Mat gives you some great ideas for improving foot stability.

 

You can even use the single leg squat as an assessment tool to see how well your system functions. Read the article - How To Use The Single Leg Squat As An Assessment to see the checklist we use to look for weakness and energy leaks.

Two other great articles to read that have many video examples and detailed explanations of how to execute many of the exercises discussed in this article are below.

We have many great FREE REPORTS you can get by clicking here. Without doubt our best program is the Functional Training free report you can get by clicking the image below.

Summary

I hope you have enjoyed this article about a joint not many of us give much thought to. But when you consider just how much influence it has on how we move you can see how critical it is to make sure it moves correctly. If you are suffering with an injury in your lower limbs or hips I would take the time to really apply everything we have discussed here and try to improve your foot and big toe function. The effort is well worth it for I can tell you first hand how much better I move from completing many of the simple drills and exercises featured in this article, not to mention observing the incredible improvement of many complex cases who come to see us each week.

The big toe is everything to how you move!

For more ideas and information on specific topics I may not have covered in detail be sure to check out our INDEX PAGE on the website that has over 300 of our best articles. These are all sorted into categories for quick reference so you can find what you are after more easily. You can also subscribe to our FREE fortnightly newsletter by clicking here.

If you do need specific help with your exercise program please feel free to reach out to me for help and we can set you up with your individualised program.

About The Author

Nick Jack is owner of No Regrets Personal Training and has over 15 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specialises in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.

References:

  • Barefoot Strong - By Dr Emily Splichal
  • Whole Body Barefoot - By Katy Bowman
  • Born To Run - Chris McDougal
  • The Vital Glutes - By John Gibbons
  • Movement - By Gray Cook
  • Corrective Exercise Solutions - by Evan Osar
  • Diagnosis & Treatment Of Movement Impairment Syndromes - By Shirley Sahrman
  • Core Stability - by Peak Performance
  • Athletic Body in Balance - by Gray Cook
  • Anatomy Trains - by Thomas Meyers
  • Motor Learning and Performance - By Richard A Schmidt and Timothy D Lee
  • Assessment & Treatment Of Muscle Imbalance - By Vladimir Janda
  • How To Eat, Move & Be Healthy by Paul Chek
  • Scientific Core Conditioning Correspondence Course - By Paul Chek
  • Advanced Program Design - By Paul Chek
  • Twist Conditioning Sports Movement - By Peter Twist