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Toe-spread-out exercise improves hallux valgus angle

Discussion in 'General Issues and Discussion Forum' started by NewsBot, May 23, 2015.

  1. NewsBot

    NewsBot The Admin that posts the news.


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    Effect of toe-spread-out exercise on hallux valgus angle and cross-sectional area of abductor hallucis muscle in subjects with hallux valgus.
    Kim MH, Yi CH, Weon JH, Cynn HS, Jung DY, Kwon OY
    J Phys Ther Sci. 2015 Apr;27(4):1019-22.
  2. Leopold

    Leopold Member

    Should the Toes-spead-out exercise be performed with the hallux, and perhaps all the toes, touching the ground? Functionally the Abductor Hallucis should increase hallux GRF, so should it also be attempted to be trained in the same way?
    Is there a good video out there for this exercise?
    I find my clients have a very difficult time figuring the TSO out. I feel that I need a better arsenal of verbal or visual cues to help them along.
  3. Ralph Tilney

    Ralph Tilney Welcome New Poster

    video of toes-spread-out exercise:
    Last edited by a moderator: Sep 22, 2016
  4. Ina

    Ina Active Member

    This video exercise looks slightly different from the research exercise where the subjects:

    "...were trained to perform the TSO exercise following the method described by Keller12). The subjects were instructed to lift all toes while keeping the metatarsal heads and heel on the floor, and to then push the little toe downward, in a lateral direction, while pushing the big toe slowly downward in a medial direction".

    I passed this link to a person willing to try it out and he came back saying he failed to find explicit directions regarding ankle and knee positions while performing the research version of TSO exercise. Is it safe to assume that it is the same as during this measurement? "For the measurement of the HV angle during active abduction of the hallux, subjects sat on a chair situated above the radiographic table, and assumed a 90 degrees flexion angle between the hip and knee, with the ankle maintained in the neutral position (i.e., 0 degree)."

    The yoga article the research is referring to (Keller D.: Yoga Plus Joyful Living Magazine. November?December 2008, 72?79) gives rather vague directions at the discretion of the reader: "sit on the floor or on a chair with your knees bent and your feet parallel". There's a picture of this exercise (Fig.7) where the ankle appears to be in the neutral position and elsewhere in the text the author states "The toe exercises are particularly effective and important to practice in the standing poses of hatha yoga. Asanas in which the ankle is neutral..." http://www.doyoga.com/articles_all/15_nov_08_bunions.pdf)

    The efectiveness of the exercise probably may be evaluated and utilized apart from the theory behind it but I wonder what are the current views in physiotherapy on Keller's reasoning of his exercise, specifically that "This builds the transverse arch at the front of the foot, as well as strongly working both the inner and outer edges of the foot, which energizes and balances the inner and outer arches."

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