The majority of our society thinks that we must support our arches to improve foot function or reduce pain. Daily in my practice I have patients tell me “I know I have flat feet….” and then go on to describe a problem or situation they believe to be related to their arches although is not. It is important to understand our arches are a variant of foot types. Some may have a high arch and some may have a low arch but it really has no bearing on whether or not they will develop foot pain or further deformities. Some extreme cases of “high arches” or “flat feet” can lead to pain and further problems but these are true pathologic deformities that exist in probably less the 5% of the population. In other words, you would probably have a difficult time even walking, let alone running, with this type of foot structure and it would clearly be a deformity to even a non medical individual.
Rarely do we think of our toes as being an important part of our foot “structure” or as to even what role they play in walking or running. In fact, most of what we learn in podiatry school and residency in regards to toes is how to fix a deformed toe, not how to prevent them.
Our toes play an important role in stabilizing our feet during during the gait cycle by grabbing the ground and preparing the rest of the foot for landing. The purpose of this article is not to discuss the complex biomechanics of the foot, yet I want to simply point out how we ignore our toes and basically make them non functional which leads to problems.
To start with, here is a popular photo of how our feet should appear when not subjected to traditional shoe gear that our society wears.
Over time, when our toes are not active because of being squished into shoes, the muscles known as the intrinsic muscles, atrophy (become weak) and are unable to hold the toes and foot in their natural anatomic position. Think of someone who has poor posture from very weak back musculature. When the postural muscles of our back become weak from disuse, one develops a slouched position which can be reversed if recognized early enough and strengthening exercises are initiated.
When the muscles of our toes become weak, they can develop a curled or deformed appearance. This also leads to an inability to function adequately in helping to control the rest of the foot’s function. As the muscles weaken, the toes move closer together which hinders the foots functioning as well as leads to painful situations such as corns and hammer toes.
Spacers for between toes and corn pads have existed for years but they do nothing more then decrease pressure to the calloused area or corn between the toes. A product known as Correct Toes which was created by podiatrist Ray McClanahan functions by keeping all five toes evenly spread to encourage a more anatomical “functioning” of the foot. Not only are the toes held apart to reduce the painful pressure caused by bunions and hammer toes, but the foot can function better because when the intrinsic muscles contract the toes can now assist in stabilizing the rest of the foot during foot strike. It is important to understand that, depending on the severity, the deformity may not be permanently corrected but improved while wearing Correct Toes. However, if recognized early enough and boney changes (arthritis) has not occurred, reversal of the deformity could happen as the muscles strengthen.
Correct toes can be worn with your shoes assuming the toe box is wide enough. If they don’t fit, then your shoe is too narrow and creating more harm for your foot. A minimalist running shoe will accommodate Correct Toes.
Mark Cucuzzella, family physician and elite marathoner, wears correct toes when running.
Corrected Toes Can Be Purchased here.
Simple exercises to improve toe strength and function can be seen here.