The Importance of a Roomy Toe Box for Foot Health

Strengthen Your Toes: The Key to Reducing Fall Risk and Foot Pain

Every day in my office, I examine my patients lower extremity musculature, which includes the muscle strength of our toes. In my 25-year career, I have been surprised at how weak toes become. When I examine patients, I ask them to flex and extend all 10 of their toes. I have found that weakness is directly proportional to age, the older someone is, the weaker their toes tend to be. I have come to believe this is due to the use of traditional narrow toe box shoes. You've likely heard the phrase, "If you don’t use it, you lose it." Well, with traditional narrow toe box shoes, our toe musculature is not engaged to the extent it would be if we were barefoot. Over time, those muscles are responsible for toe strength weakening.

Toe strength is actually very important. It is one of the strongest indicators for fall risk as we age. If you have weak toes, you are at a greater chance of falling. Conversely, if you have strong toes, your chance of falling decreases. In my daily practice, I encourage patients to wear shoes with a roomier toe box. This allows the toes to function in a more anatomical and natural way, keeping the toe musculature engaged.

There Are Also Three Specific Medical Or Pathological Problems That Also Benefit From A Roomy Toe Box

1. Neuromas

A neuroma is a swollen and painful nerve in the forefoot. Often, neuromas can be caused by a narrow or tight toe box. A narrow toe box can put pressure on the metatarsals, squeezing these bones and pinching the nerve, causing inflammation. Utilizing a supportive shoe with a wider toe box can allow the forefoot to spread out and avoid that pressure on the nerve.

2. Bunions

Bunions are an enlarged big toe joint caused by the deviation of the first metatarsal bone and therefore deviation of the big toe. The standard American shoe is not designed for extra room for a bunion bump. Shoe pressure against this bump can cause significant pain; therefore, wearing a shoe with added room in the toe box can instantly help reduce that shoe pressure pain.

3. Hammertoes

Hammertoes are a contracture of the toe or a deviation from the normal position. The traditional narrow toe box shoe can cause significant pain to a hammertoe due to the pressure from the shoe. Here again, a shoe with extra room in the toe box can help avoid that shoe pressure.

In closing, treat your toes well to keep them healthy and happy. A very simple exercise that you can do at the end of the day, while sitting comfortably in front of the television with your shoes and socks off, is to simply flex your toes up and down. Engage your toe muscles, engage all five toes, and do this repetitively to strengthen those individual toe muscles.

Written by
Dr. Jeffrey S. Hurless
DPM, FACFAS Board Certified Foot & Ankle Surgeon/Podiatrist
Medical Director,
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