Foot, Ankle, and Hip Function Part 2
Continuing our series on the foot, ankle and hip function, I will talk about toe splay (spreading out your toes) and how the narrow toe box design of modern shoes impacts the function of your foot and can lead to injury.
The design of modern shoes has a narrow toe box. This design is not built for a healthy foot because when you look at the design of your foot, the toes are the widest part. A wide toe splay is necessary for stability and balance. You might have noticed that many people, especially women who wear high heels, often have deformities such as bunions. We grow up with our feet spending a large amount of time in shoes which, while putting even the slightest amount of pressure on our toes, dictates the direction of the bone growth.
Like a weed that weaves and winds its way through the tiny cracks of a cement sidewalk, our toes will grow in the direction that they are essentially shoved through. This can have a big impact on your balance and stability on your feet.
Is it easier to stand on something narrow or something wide?
As you may have guessed, having a wide base of support is optimal. A shoe should be designed to allow our feet and toes to splay out wide to increase our base of support.
The 'big toe' plays a major role in your gait, the structure of your arch, and overall stability. The big toe is the last part of the foot in contact with the ground as you push off the back leg while walking or running. It is the strength and alignment of this big toe that allows for proper stability and force production to transfer through the ground to propel you forward.
Wearing a narrow toed shoe will push your big toe in medially, and will change the toe off point from the end of your big toe to the outside of the big toe. The result is more stress on that big toe and it will move in closer to the other toes. It then reinforces the stimulus to direct the big toe in.
If the big toe is out of alignment, you will create an unstable arch. The flexor tendon of the big toe (flexor hallucis longus) originates from the muscle that sits on the backside of your shin (tibia). The tendon of the flexor hallucis muscle runs down, behind the ankle bone (malleolus) on the inside of your leg, under your foot where is stabilizes the Medial longitudinal arch and attaches to the tip of your big toe. As the big toe gets pushed in, the flexor tendon moves with it which decreases the stability of the medial longitudinal arch.
This contributes to the collapsing of the arch. The collapsing of the arch can also lead to problems such as plantar fasciitis. This collapse and lack of stability leads to over pronation. Over pronation, in turn, allows for excessive internal hip rotation, which is visually seen as the knees collapsing in toward each other. (see pic below)
When knees are collapsing inward, it puts excessive wear and tear on the knees.
Putting it all together now, we have a big toe shifting medially, which can cause a bunion that may need surgery later, as a consequence of that, a collapsed arch can lead to plantar faciitis, and internal hip rotation, which weakens the external hip rotators. This over-stresses structures in the knee which can cause knee pain. It also compromises your ability to balance on your feet. Lack of balance is a safety issue, especially for older adults, who are already at high risk of falls. As you can see, everything is connected. When you alter what is thought to be one little, insignificant structure, it can have a large impact later on.
All of these problems can stem from extremely poor shoe design and/ or wanting to look good in something like a high heel shoe. If you don’t want to suffer these consequences, you can start working on regaining the structure and function of your feet. I can help you move towards better foot function and stability in our new class at Serratus Movement Centre coming in January 2019.
Yours in Fitness,
Kevin and Team SMC