Plantar Fasciitis and the Big Toe

The first or big toe plays a very important role in human gait and any injury or problem affecting the big toe can lead to plantar fasciitis.

Flexed big toe in walking

Flexibility of the big toe is vital to arch function

The plantar fascia is a band of tissue that stretches from the front of the heel (calcaneus) to the first joint of the big toe and the flexibility of this toe plays a vital role in shock absorption and propulsion.

If there is a loss of function or flexibility of the big toe, the windlass mechanism is incomplete and the arch of the foot no longer supported.

This loss of function and support, forces the foot to roll inward (pronate) excessively at the medial arch in order to achieve toe off.  The result, is damage to soft tissues and other bony structures of the foot.

Wearing footwear actually inhibits our natural windlass mechanism, as the soles of the shoes are usually too inflexible to allow proper flexion of the big toe.

 

 

Common big toe problems

The big toe can become damaged as a result of;

  • Injury or previous surgery
  • Being forced into tight shoes
  • Wearing flip flops or loose footwear – forcing the big toe to operate with a gripping action
  • Bunions which force the toe out of alignment
  • Wear and tear – Osteoarthritis
  • Rheumatoid conditions and diseases such as gout.

Treatment

The first problem to overcome is diagnosis, as a majority of these patients will be incorrectly diagnosed with a “fallen arch”.  What must be understood, is that the collapsing of the arch structure is a symptom and not a cause.  Architecturally, the integrity of an arch relies on the stability of the supporting structures at either end and the foot is no exception.

The supporting sructures

Instead of supporting the arch, treatment is aimed at correction of the mechanics of the big toe and any other affected structure.

Many of these problems can easily be alleviated by few sessions with a qualified practitioner who can perform remedial treatments to manipulate the structures around the toe and foot, allowing the bones and soft tissues more flexibility.

People often report a dramatic change in their foot pain and much improved flexibility, which can, depending on the condition, be long lasting.

More information

The Sportsphysio.com – Functional feet treatment.

Daniel Howell Ph.D. – The Barefoot Professor – Associate Professor of Biology at Liberty University

The video below  by Dr. Daniel Howell, explains the windlass mechanism of the human foot.

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