Toe Flexion

I. Description of Motion

Toe flexion results in a decreased angle between the phalanges of the toes and the plantar surface of the foot.

The muscles involved in toe flexion include the flexor digitorum brevis, lumbricals, interossei, flexor hallicus brevis, flexor digitorum brevis, flexor hallucis longus, flexor digiti minimi brevis, flexor digitorum longus, and quadratus plantae.

The tibial nerve innnervates the flexor digitorum longus and the flexor hallucis longus. The medial plantar nerve innervates the flexor digitorum brevis, the flexor hallucis brevis and the first lumbrical. The lateral plantar nerve innervates the quadratus plantae, flexor digiti minimi brevis, the interossei, and the three remaining lumbricals.

II. Mobilizing - Increasing Range of Motion

1.) You can use a hand towel or similar piece of cloth to stretch your toe flexors. Begin by sitting on the floor and wrapping the towel around the toe to be stretched. Gently pull back until a stretched is felt. Hold for 30 seconds and repeat 3 times. Additionally, multiple toes or all the toes can be stretched using this method.

2.) Another stretch for your toe flexors begins by sitting in a chair. Cross the foot to be stretched over the opposite leg and grasp your toes with the same hand as foot to be stretched. Supporting the heel with the opposite hand, pull back on your toes until you feel a stretch. Hold for 30 seconds and repeat 3 times.

3.) This stretch begins in a kneeling posture. Next, lean forward and extend your toes underneath your body. Gradually lean back until you feel a stretch on your toes and on the bottom of your feet. Hold for 30 seconds and repeat 3 times. To increase the depth of this stretch, further lean your body posteriorly over your toes.

Watch the video below to see a demonstration of these stretches.

III. Indications for Stretching

Chronic static stretching of the lower extremities has been shown to improve exercise performance independent of strength training.1

IV. Strengthening

1.) To strengthen your toe flexors, first place your bare foot on a flat towel. While keeping your heel on the ground, flex your toes to bring the towel underneath your foot. Repeat 10 times and perform 3 sets. To increase the difficulty of this progression, perform this exercise with both feet at the same time. To further increase the difficulty of this progression, lean your body forward to increase the resistance placed on the toe flexors.

Watch the video below to see a demonstration of this exercise.

2.) Another toe flexor exercise utilizes a theraband. While sitting on the floor, place the theraband along the ball of your foot and toes while keeping your knee extended and foot plantarflexed. Keep tension on both ends of the theraband while bringing your toes into flexion. Repeat 10 times and perform 3 sets. Use a theraband strength that will bring you close to fatigue after completing the third set. To increase the difficulty of this exercise, use a stronger theraband.

Watch the video below to see a demonstration of this exercise.

3.) This toe flexor exercise begins with the person raising onto the balls of their feet and balancing there for 60 seconds using the table for minimal support. To increase the difficultly of this exercise, do not use the table for support. To further increase the difficulty of this exercise, balance on one foot, again using the table for minimal support and progress to balancing on one foot without support.

Watch the video below to see a demonstration of this exercise.

V. Potential Clinical Syndromes and Etiologies

Strengthening and stretching of the toe flexors can help reduce the symptoms of plantar fasciitis.2

VI. Additional Web Based Resources

Click the link below to learn more about plantar fasciitis.
http://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/basics/definition/con-20025664

VII. References

1.) Kokkonen J, Nelson AG, Eldredge C, Winchester JB. Chronic Static Stretching Improves Exercise Performance: Medicine & Science in Sports & Exercise 2007;39(10):1825-1831. doi:10.1249/mss.0b013e3181238a2b.

2.) Fasciitis P. Plantar fasciitis: diagnosis and therapeutic considerations. Alternative medicine review 2005;10(2):83–93.

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