Why do We have Toes

So why do we have toes?

That is an interesting question isn't it?  So many times our toes get ignored until they become injured. I bring this question up because so in the past my patients have asked me this question.  I mean after all when we do injure, such as a fracture we really do not treat them.  I just tell my patients to stay off their foot..

However, the honest truth is we do need them.  It comes down to simple physics.  The wider the base of something, the more stable it is.  So  when we use our toes, they extend and splay, this allows the foot to be wider in the forefoot.   Let's talk about what happens with our hands when we do a push up.  If we do the push up with our hands made into a fist, it will be much difficult. Our arms will “shake” and be less stable. Yes, it will recruit more muscle contraction which can strengthen the stabilizers of the shoulder, but the point is the muscles have to work harder. This is analogous to the foot where if the base is narrow, then the foot will be unstable forcing the leg muscles to work harder, which will intern lead to an overuse issue.  This will in return affect the way we walk.   

I have preached this to my patients many of times.  Our feet need to be strong. Many people do not realize this, but the tendons that flex our toes originate from muscles in the calf. Specifically the flexor hallucis longus (FHL) and flexor digitorum longus (FDL) muscles are calf muscles which not only flex the great toe and lesser toes, but also serve as plantar flexors for the ankle. By simply doing calf raises, you will strengthen these two muscles which will improve plantarflexion as well as make the toes toes stronger to grip the ground during landing. The FHL and FDL are two of the three major muscles (third being the gastrocnemius complex) that plantar flex the ankle as well as play a role in propulsion.

I recommend to my patients with plantar fasciits as well as to all runners to perform  calf raises each and every day.   They should be done barefoot, and focusing on splaying the toes and gripping the ground. When done barefoot, the patient will engage the FDL.

 Many physical therapists however, have been advising to do high repetition strength training in order to fatigue the leg muscles as they need to be fatigued. I am still on the fence here. While Maffetone makes sense, I have seen as well as experienced results from the high repetition calf raises. It would be interesting to see Phil’s response to this!