Toe Strength Guidelines / ActiveSTL - St. Louis Sports Chiropractor

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Dr. Brennan Donahue is a Chiropractic Physician with ActiveSTL in St. Louis, Missouri. At ActiveSTL we believe that everyone should have a pain-free, active lifestyle.
ActiveSTL is located in St.Louis, MO. We specialize in evidence-based, conservative care for weekend warriors, dedicated athletes, and desk workers.
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Today we're delving into the intricacies of foot strength and why it sometimes falters. When it comes to foot and ankle injuries, understanding the strength in and around these areas is crucial. One key aspect we assess is the arch height. Do they pronate excessively? Or do they supinate too much? Can we slide fingers underneath comfortably? One test we often employ is the navicular drift test, though we won't cover it today. Essentially, it observes if the arch transitions from a flatter position to a more supinated one when moving from seated to standing.
We also focus on toe mobility. Let's try a bit of "toe yoga". Can you lift just the big toe? Now, can you lift the other four toes while keeping the big one grounded? Inadequate big toe mobility can lead to walking alterations, causing compensations further up the lower chain.
Next, let's gauge dorsiflexion. I'll gently lift the foot, aiming for around a 45-degree angle from the floor. Achieving this indicates good dorsiflexion, which we can work on accessing more efficiently.
Moving on, we'll test toe strength. Stand with feet hip-width apart. Ideally, we'd use a wall for support, but for demonstration purposes, we'll proceed without. Lift and spread your toes, grip the ground, then lean your weight forward. Notice the creases in the toes? That signals activation of the flexor digitorum brevis muscle, crucial for toe strength.
To accurately measure strength, especially in the big toe, we need a baseline. Here, we use a force gauge. I'll place it under your big toe, and as you grip the ground, resist my pull. Excellent, we've got a reading of about 25.1 pounds. We aim for at least 10% of body weight for the big toe's strength.
Similarly, we test the other toes. Again, grip the ground and resist my pull. Fantastic, we're seeing about 20.2 pounds of force, which ideally should be about 50% of the big toe's strength.
These metrics provide a solid starting point for our treatment plan. As we progress with exercises and perhaps modify footwear, we'll monitor changes in foot function and strength to ensure effective progress.