Foot and Toe Assessment

Overview

talk about the arch and how the toe flexors work

Great Toe Extension

  • Flexor hallicus longus performs great toe flexion, assists with plantar flexion, and supports the medial longitudinal arch.
  • For normal gait (walking & running) the great toe must be able to extend at least 70 degrees. If this is not available, the client will compensate by walking with a toe-out gait (external rotation of leg), which will cause increased pronation and stress on the medial side of the 1st MTP joint, leading to bunions
  • Hammer toe deformity means both the toe flexors and extensors are short
  • A client with hammer toes will dorsiflex the ankle using the toe extensors as the dominant muscle, instead of the tibialis anterior
  • Toe extension when rising from a seated position means the center of gravity is too far posterior and they are trying to pull themselves forward
  • Flexor digitorum brevis is often weak in clients with plantar fasciitis
  • For clients with plantar fasciitis, instruct clients to flex toes on push-off phase of gait

Great Toe Assessment

The best assessment the great toe is done in weight bearing, because this will prevent plantar flexion of the 1st ray. Have the client stand and the therapist simply tries to passively extend (DF) the great toe. We should see about ??? degrees of extension at the MTP joint.

You should also notice the tibia externally rotating as the great toe extends.