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Home » Anatomy, Orthopedic Assessment

Big Toe Extension and Hip Rotation

Submitted by on March 22, 2009 – 8:29 amNo Comment

The next time you have client who walks with their feet pointed out (“duck footed”), check their ability to extend their big toe (great toe).

Foot toe-off

Foot toe-off

Here’s why:

During normal gait (walking) our body travels forward over our stance leg, and the heel will lift off the ground to help propel us.  As the heel lifts, the body weight shifts forward on the foot and the toes must extend.  The big toe is critical to this action, because the body weight shifts toward the medial forefoot during push-off.

If the big toe cannot extend 65-70 degrees, the forefoot cannot accept this weight shift as the heel lifts.  Because our bodies are great at adapting movement, we will create faulty movement patterns in the foot, shin and hip to compensate for the lack of big toe extension.

First, we will walk with our feet pointed out.  Why does this help?  It allows the body weight to roll off the inside edge of the foot, since it cannot travel along the length of the inflexible big toe.  This gait pattern requires the femur and tibia to stay in an externally rotated position.  To maintain this movement pattern, our gluteus maximus, piriformis, and biceps femoris will  hold in a shortened position.

When the body weight is focused on the inside edge of the foot, it will cause the medial longitudinal arch to collapse and the foot will over-pronate.  Walking in this posture will lead to a shortening of the peroneals, as well as the lateral gastrocnemius and soleus, while also increasing the strain on the plantar fascia and muscles of the medial shin (medial shin splints).

So, if you find a client with limited big toe extension, here are some key muscles needing attention with massage and stretching:

  1. Big (great) toe flexors – Flexor hallicus longus and brevis
  2. Ankle everters – the peroneals and lateral calf (gastrocnemius & soleus)
  3. Hip external rotators – Biceps femoris (including the short head), gluteus maximus and piriformis
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