A really cool thing I saw whilst having a nosey at an article when I should be having some wine, was the function of toes.
A pretty obvious thing right? However, prehistorically the function of toes was to grip uneven surfaces however, now that everything is flat (not a flat-earther) suffice to say we don’t need to grip the way our ancestors needed to. So….. that begs the question. What are our toes doing? WELL! I’m glad you asked, unsuspecting passer-by! According to Huges et al., 1990, now their function is to increase the weight-bearing area so during gait the gait cycle, our metatarsal heads aren’t bearing the full force of the toe-off phase (Huges, et al., 1990). Pretty cool right?
So why am I talking about this in a blog post regarding silicone toe props, again, so happy you’re asking these important life-changing questions! Patience, young grasshopper. I’m getting to my point relatively soon.
As is the joy of a rabbit hole, I went down one named Lambrinudi and was not disappointed. Lambrinudi disputed that being able to displace weight onto the toes during the gait cycle was effective as long as the feet were on a flat surface and the intrinsic muscles contracted in sync with the long flexors. Therefore, in feet where there is a reduction in this synchronicity, a deformity would be present (Rogers, et al., 2018).
These are known as lesser-toe deformities and we learn about them in podiatry so knowing about silicone toe-props and the different types of toe props is very important to us as podiatry students since we use them in practice! (Johnson, et al., 2012). Building on Lambrinudi’s concept, an article written by Shirzad, et al., 2011, further clarify what lesser toe deformities mean, stating that they’re caused by changes in normal anatomy and this impacts the balance between the intrinsic and extrinsic muscles in our feet. Shirzad, et al., 2011 further discuss the different types of lesser digit deformities so I highly recommend reading the article from the references below (Shirzad, et al., 2011).
Okay, back to the topic at hand, toe props. A study was done by Johnson, et al., 2012 take a look at the effect of three different kinds of toe props on lesser toe deformities and how plantar pressure and patient comfort is impacted (Johnson, et al., 2012). To summarize their paper, silicone toe props were clear winners in terms of patient comfort and distribution of plantar pressure. Gel toe props reported a higher patient comfort satisfaction when compared to their leather counterpart. So the study concluded that silicone toe-props were the ideal primary treatment plan to reduce pressure for second toe apex lesions caused by high digital plantar pressure (Johnson, et al., 2012).
References
Huges, J., Clark, P. & Klenerman, L., 1990. The Importance of Toes in Walking. The Bone and Joint Journal, 72-B(2), pp. 245-251.
Johnson, S., Branthwaite, H., Naemi, R. & Chockalingam, N., 2012. The effect of three different toe props on plantar pressure and patient comfort. Journal of foot and ankle research, 5(22).
Rogers, M., Ghassemi, A., Sharp, R. & Cooke, P., 2018. The Lambrinudi Triple Arthrodesis. Orthopaedic Proceedings, 94-B(SUPP_XLIII).
Shirzad, K. M., Kiesau, C. D. M., James, K. M. & Parekh, S. G. M. M., 2011. Lesser Toe Deformities. Journal of the American Academy of Orthopaedic Surgeons, 19(8), pp. 505-514.
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