In the world of health care, there are no panaceas, or cure-alls. But a few simple strategies can have profound and lasting effects on health. When it comes to building and maintaining foot and toe health, one simple action stands out above most others: realigning the big toe to the position that nature intended. Restoring the big toe so that it’s in line with its corresponding metatarsal bone is one of the most powerful and effective ways to treat a variety of foot problems—everything from bunions to neuromas to plantar fasciosis—and improve foot function.
Many of us who have worn conventional footwear most of our lives have big toes that are deviated toward the midlines of our feet. In this configuration, the big toe visibly sits at an angle relative to its corresponding metatarsal bone; the other toes, especially the fifth toe, may also deviate from their intended positions. This configuration is known as hallux valgus, and though it is common, it is not in any way normal. The forces associated with tapering toe boxes are directly responsible for this big toe deformity (the heel elevation included in most footwear is another major player in this problem, as it puts a tremendous amount of force or pressure on already-wedged toes). Even conventional socks, to some degree, contribute to this exceedingly common foot problem by applying pinch forces on the toes.
Nature intended the toes to be splayed well apart, and this foot shape can still be seen in infants and in individuals from barefoot or minimally-shod cultures. In this article, I offer six compelling reasons to reposition your big toe to the location that nature intended, and I offer a few simple strategies on how best to accomplish this health goal (it is possible for most people to restore proper big toe orientation). Read on to learn about the six reasons why you should realign your big toe.
1. To Enable Natural Arch Support
Returning the big toe from a deviated position to its intended position helps encourage natural arch support. The two ends of the main foot arch are the heel and the forefoot (including the toes). The foot arch is most stable when two conditions are satisfied:
1. The heel and forefoot are positioned on a level plane
2. The toes (especially the big toe) are splayed well apart
When the foot and toes are in this configuration, the arch is able to bear a tremendous amount of weight. In fact, the more weight that's applied to the arch, the stronger the arch becomes (assuming that the foot and toes are in their optimal orientation and position).
2. To Prevent Excessive Pronation & Ankle Sprains
Excessive pronation (inward rolling of the ankle) is a common situation in the conventionally shod, as are ankle sprains. Excessive pronation can lead to many foot and lower extremity musculoskeletal problems. Conventional footwear possesses three design features that actually promote excessive pronation: heel elevation, toe spring, and tapering toe boxes. These design features lift the heel and toes above the ball of the foot and pinch the toes together. In this configuration, the foot becomes extremely unstable and can do little else but overpronate.
Some conventional shoes attempt to control this instability by adding pronation control features, but this is little more than a temporary fix to a much larger problem (and it’s not always effective in achieving pronation control). Shifting the big toe to its intended position in line with the first metatarsal bone actually has a supinatory (i.e., the opposite of pronation) effect on the rest of the foot.
Restoring the big toe to its natural location will also help reduce the chances of an ankle sprain. When the big toe is in this position, and when footwear is used that places the foot on a completely level surface, a person is much less likely to suffer an ankle roll, as, without a heel, there is less distance to roll and the big toe helps stabilize the entire foot.
3. To Improve Blood Flow to the Plantar Fascia
Reduced blood flow, or circulation, to and from the plantar fascia (the thick connective tissue that supports the medial longitudinal foot arch, or main foot arch) can lead to degeneration and death in this tissue. The abductor hallucis muscle—the muscle responsible for moving the big toe away from the rest of the foot—becomes overstretched and weak in people who wear conventional shoes that possess tapering toe boxes. Traditional wedge-shaped toe boxes force the big toe toward the foot’s midline—an action that causes the abductor hallucis muscle to pull on another connective tissue structure (the flexor retinaculum), under which sensitive structures pass.
One such structure is the posterior tibial artery. Diminished blood flow through this artery means that the plantar fascia does not receive adequate blood flow to support its metabolic processes. Plantar fascia tissue begins to die and cannot be cleared because there is a lack of circulation, and this is what causes the pain that most people (including many doctors) attribute to plantar fasciitis. The “itis” of plantar fasciitis implies inflammation, but no inflammation is usually present with this condition. Instead, it’s tissue degeneration that is seen at a microscopic level in people with this health problem.
Restoring the big toe to its normal anatomical position relieves the tension on the flexor retinaculum and reduces pressure on the blood vessels that pass beneath, allowing adequate blood flow to reach the plantar fascia and exit, washing dead tissue away.
4. To Restore Proper Sesamoid Bone Orientation
Two small bones, sesamoids, sit directly underneath the joint connecting the big toe to its corresponding metatarsal bone. Both sesamoid bones sit within the tendons of the flexor hallucis brevis muscle. The foot sesamoid bones provide a smooth surface over which the big toe flexor tendons can slide, and they improve the ability of these tendons to transfer force from the lower leg muscles to the base of the big toe. The foot sesamoid bones also help bear some of the bodyweight and reduce stress on the other forefoot structures.
A person may develop problems (such as sesamoiditis) if he or she wears conventional footwear for prolonged periods. Shoes with tapering toe boxes that force the big toe into a wedge position may cause the sesamoid bones to become dislocated, which in turn leads to dysfunction. When the big toe is properly aligned with the first metatarsal bone, the sesamoids are also properly aligned and function the way nature intended.
5. To Enhance Balance & Weight Distribution
Restoring the big toe to its proper orientation helps improve balance and spreads bodyweight forces more evenly over the surface of the foot. With the big toe properly aligned, the foot acts like a tripod to keep a person upright and his or her foot stable. The wider the toe splay, the better balance a person will have. Spreading the toes, especially the big toe, can be particularly helpful for seniors or individuals who struggle with balance problems, and it may even help reduce the likelihood of falls.
Splaying the toes fully will help spread bodyweight over a greater surface area on the sole of the foot and reduce point pressure on just one aspect of the foot (the ball of the foot, in most cases). Reducing the pressure on the ball of the foot helps reduce the chances of developing common ball of foot problems, include neuromas and stress fractures.
6. To Boost Intrinsic Foot Muscle Strength
Intrinsic foot muscles (all four layers of them) are located within the foot and primarily serve to provide dynamic support for the medial longitudinal foot arch. These muscles exist only within the confines of the foot and do not cross the ankle. In conventional footwear, intrinsic foot muscles become weak and ineffective, as they are often immobilized for long periods (due to the rigid soles included in traditional shoes). It’s not until conventional footwear is abandoned (and healthy footwear adopted) that these muscles "wake up" and participate more fully in the act of walking, running, and weight-bearing.
The simple act of restoring the big toe to its intended position can have a very favorable effect on the intrinsic foot muscles. With the big toe in this position, the intrinsic foot muscles will fire more frequently, become stronger, and help improve the integrity of the main foot arch.
How to Restore Normal Big Toe Position
Restoring proper big toe position is a powerful way to realize lasting foot health benefits and eliminate common causes of chronic foot problems. Here are some of the top ways to restore normal big toe orientation:
Use Correct Toes: Correct Toes toe spacers are an amazing tool for restoring natural toe splay, especially big toe position. These toe spacers are made of medical-grade silicone, making them both comfortable and durable. They can be worn inside shoes that possess a compatible toe box.
Use Toe Socks: Toe socks—socks that have a separate compartment, or sleeve, for each toe—are helpful in enabling proper big toe alignment. Unlike conventional socks, toe socks do not contribute to big toe deformation, instead allowing the toes to splay the way nature intended.
Adopt Foot-Healthy Footwear: Shoes and other footwear that possess a sufficiently wide toe box to allow for natural toe splay are absolutely crucial in restoring proper big toe orientation. Truly wide toe boxes (i.e., toe boxes that are widest at the ends of the toes) are rare, and it can be challenging to find them. Shoes described as “wide” aren’t always wide where it matters (i.e., at the ends of the toes, not the ball of the foot). Every shoe or footwear option on the Natural Footgear site for men and women possesses a truly wide toe box to enable proper toe splay.
Perform Relevant Stretches & Exercises: Certain stretches, especially the Big Toe Stretch, are excellent for realigning the big toe with the first metatarsal bone. A person can also loop an elastic band around both big toes and gently spread his or her feet apart, stretching the big toes away from the rest of the foot.
Big toe rehabilitation takes time! You are trying to counteract years of damage caused by conventional footwear, so be patient and monitor your progress. Check out our Correct Toes Results & Expectations page to learn more about how this toe-spacing device can help you successfully restore your big toe to the position that nature intended. I wish you great success on your journey toward optimal foot health!