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What are Normal toes and what purpose do they serve?

 

The five functions of your toes.

 

Having a good sense and understanding on how a normal toe should function will allow you to have a “standard” for comparison of any impairments of those functions usually experienced by you as “symptoms”.

 

But first— what do we mean by “function”?

 

The definition that applies is: function noun an activity or purpose natural to or intended for a person or thing

 

So the functions of our toes would be those natural useful activities that are inherent in toes that are a part of the normal operation your body. There is a broad professional consensus that the toe functions are:

  • upright balance
  • weight bearing
  • propulsion in walking

 

Since weight bearing is part of walking anyway, I will combine propulsion and weight bearing into one function (moving around), and I will add another another toe function called sensory feedback. So the natural list of toe functions are three in number:

  • upright balance
  • moving around
  • sensory feedback

 

Of course the definition of function above also states “an activity or purpose natural to or intended for a person or thing. So are there any purposes you would intend for your toes to do?—well two purposes stand right out—your toes really need to function in your shoes and they need to function visually in a socially acceptable way. So the list of toe functions is now expanded to three natural functions and two intended functions:

  • upright balance
  • moving around
  • provide sensory feedback
  • tolerating shoes
  • presenting a socially acceptable appearance

 

I will go through each of the 5 toe functions in more detail below.

 

The five functions of toes

 

Upright Balance

 

Your toes are directly connected to the arch through specialized structures that contributes to the overall stability of your whole foot. Also your toes can deliver a quick and powerful push to the floor if your body is leaning forward too much, thus forcing your body backwards to regain balance. Your toes constantly adjust their pressure to maintain your body and head to remain stably and steadily upright all day long—much like the flaps on a airplane’s wing can direct the body of the plane to maintain a steady position throughout fast and changing wind conditions.

 

Moving around

 

Your toes increase your weight bearing area during walking, running, etc. Your toes can also exert similar pressures on the floor as your metatarsals (balls of the feet) do. A leading study1 concludes that every effort should be taken to preserve the weight bearing function of toes. You can confirm this yourself by scrunching up your toes to a point where the balls of you feet are actually barely touching the floor. You can actually walk some distance that way. If fact many people who have metatarsal pain and/or painful bottom callouses subconsciously relieve the excessive weight bearing on those areas by contracting the toes and lifting. Of course if that is done for too long a time permanent contractions of the toes called Hammertoes can develop.

 

Sensory Feedback

 

Your toes “feel” the ground contact, “register” the amount of pressure of that contact, and “detect” objects in the walking path (bedposts come to mind-OUCH!). All that sensory information is used by the nervous system to control the other natural functions like balance and movement. Implied in this function is that toes should have there own inherent ability to move on their own with enough flexibility and range of motion to provide the sensory feedback described above.

 

Tolerating Shoes

 

Toes need to exist in and behave themselves in shoes for many hours on end everyday. Most of us need to wear shoes regularly and since shoes are manufactured with impersonal standard discrete lengths, widths, and shapes, you may have trouble getting your feet and toes to tolerate those shoes for very long often resulting in the toes deforming and becoming painful thus inhibiting the other functions of the toes. In fact I find that this “tolerating shoes” function has more failures on my patients then all the other functions combined.

 

Presenting a socially acceptable appearance

 

I include this toe function as I have met, examined and treated literally thousands of patients who regularly hide their (“unacceptable”) toes from public view (sometimes their husbands), never wear open sandals or flip flops, feel uncomfortable going to summer dinner parties, and won’t walk on the beach. People spend billions and billions of dollars on “appearance’ improvers (clothes, cosmetics, hair products, along with surgical procedures designed to improve the appearance of their teeth, nose, breasts, butts, wrinkles, baldness, abdominal fat, scars, etc.

 

Keep in mind the following

 

The goals of any conservative or surgical treatment of the toes should try to aim to preserve, restore, or enhance any defects or impairments the 5 functions above and the symptoms of hammertoes are directly related to some sort of of impairment(s) of the above four functions of normal toes.

 


Larry A Keyes DPMDr. Larry Keyes is a podiatrist in Oak Park, IL. Since 1998, he's been changing his patients' lives after perfecting a safe, simple and zero-downtime solution to correcting hammertoes, the removal of corns and prevention of keloids.

1023 Madison Street, Oak Park, IL 60302
708-771-4300

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