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Effects of Toe Spreaders

Discussion in 'General Issues and Discussion Forum' started by NewsBot, Sep 19, 2013.

  1. NewsBot

    NewsBot The Admin that posts the news.


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    Immediate Effect of the Toe Spreader on Tibialis Anterior and Peroneus Longus Muscle Activities: a Pilot Study
    Kang Sung Lee, Eunhye Ko, Sang-Yeol Lee
    Journal of Physical Therapy Science Vol. 25 (2013) No. 3 March p. 293-295
  2. Admin2

    Admin2 Administrator Staff Member

  3. What's a toe spreader?
  4. Admin2

    Admin2 Administrator Staff Member


    Attached Files:

  5. Thanks. They are used when painting toenails - not for any therapeutic effect. Why a paper on the effect of these implements on two muscle groups?? Two short planks of wood with 6" nails may also provide medio-lateral foot support during walking. Is this next?
  6. Craig Payne

    Craig Payne Moderator

    Didn't you know that they can cure almost any foot problem?
  7. Jeez - Correct Toes, Posture Control Insoles, Foot Typing, MASS Technology - I always suspected there was an IE* class taught in some American Podiatry Schools - I used to hear some students say they were off to an "inject' class, which I assumed was LA Techniques, but I think they were really saying "ingex" which is something rather different. I wonder if there is some co-relation between the authors and the inventor....

    * Ingenious Exploitation
  8. Craig Payne

    Craig Payne Moderator

    I blame Robert and his course:
  9. wdd

    wdd Well-Known Member

    Imagine that you own the company making 'toe separators'. Things are going OK but you would like to increase your market.

    Then you have this idea, probably after reading something about Kinesio-tape. True they have been used when painting toe nails but what if they can be marketed as a therapeutic device at least for starters? After that they might be marketed as 'performance enhancers'. Then you have the extra income opportunities associated with the colour. Added to that of course is their potential as another universal panacea.

    Thinking positively. Podiatry biomechanical therapy seems, almost exclusively to boil down to a single outcome a relatively large lump of plastic that you stand on.

    Whether or not there is any therapeutic potential in toe seperators it at least offers podiatry an opportunity to increase the scope of its thinking about methods of biomechanical control.

    Best wishes,

  10. You could argue that we fit silicone digital splints with the primary aim being moderation of adverse forces on the digits/forefoot - and toe separators may be likened to these devices, however I would suggest that this would be like a dentist comparing the functionality of bespoke dentures with gum shields or dental impression cases.
  11. wdd

    wdd Well-Known Member

    I agree totally and if the dental impression case seems to be doing something that you might define as therapeutic how much more 'therapeutic' might the bespoke dentures be? Or maybe the 'dental case' would just be pointing the way and the most efficaceous device might have less than a passing resemblance to either the bespoke dentures or the dental cases while being something other than the conventional 'orthotic'?

  12. Quite right. I think I must have simply departed the bed on the wrong side the other morning when I read the abstract at the top of this thread. As time passes I guess that all the obvious research projects will have been done ad nauseum and budding students and lab rats will be challenged to find much new ground to groom their research skills. Not always easy - never was - but in times past much of the work like this would never have been published or if it had been, it was likely to remain in a publication of narrow readership. T'internet has a lot to answer for...
  13. If the "toe spreader" appliance can widen the distance between the toes, and or realign the metatarsophalangeal joints within the transverse plane, then there can be a positive mechanical effect on the foot by the use of these devices. The digits are important parts of the foot, not only allowing improved balance, but also allowing more forceful propulsion and helping to load-share with the metatarsal heads to reduce metatarsal head pressures.

    The problem I see is not in the theory that they may help some people but in the practical application of whether wearing these devices actually can reverse chronic digital deformities that are caused by years of wearing shoes that are too short and too tight at the digits (i.e. shoes that are worn by many females in western civilization from their early teen years to well after menopause). I really don't think that wearing "toe spreaders" for a few hours a day after 20 years wearing "cute shoes" will cause any permanent change in digital deformities.

    With this in mind, I see no harm in wearing them, except to the pocket book.
  14. Agree with that, Kevin. Having used silicone digital splints for as long as I can remember to alleviate a variety of problems in patients from digital lesions to inter metatarsal neuritis, I regard them as a valuable armament in the podiatrist's scope of practice. But foam toe spreaders? They may induce increased muscle activity for sure, but as a practical therapeutic device? It's a bit like suggesting sprung mattresses for cushioning devices - possibly quite effective but difficult fitting into shoes and walking with them!

    I confess to becoming somewhat cynical surrounding the explosion of sham devices over the recent years - Rothbart's PCIs for example. This latest cure-all being advertised is Arthroplex - an unlicensed drug being marketed as a cure for severe arthritis. You might find it implausible that foam toe separators can reverse arthritic changes in foot deformities, but these babies will stretch your incredulity to new bounds....

    Attached Files:

  15. wdd

    wdd Well-Known Member

  16. The shoes may be a factor, Bill, but there are others that have a greater influence. Structural anomalies within the digit - bone and joint surface irregularities, ligament and capsular dysfunction - are probably more of an impediment than muscle imbalance when trying to reduce deformity through silicone devices. In my experience, you have a greater chance of successfully realigning joint position with serial splinting when the patient is young with no structural anomalies, however the primary benefit with digital silicone devices surely being the reduction of pathological tissue stress on dorsal and apical lesions in older patients - even where reduction of deformity is not so readily achievable. They can be equally beneficial for neuritis pain in PDN or intermetatarsal bursae nerve compression - that said, they can often make symptoms worse!

    I have been amazed to see the devices manufactured for patients by some colleagues over the years. I have always constructed silicones to fit neatly within the contours of the plantar surface of the digits from the base of the proximal phalanx up to the distal IPJ. Individual digits can be buttressed with additional material to provide more lift for apical lesions, however the interesting question for me is why recalcitrant dorsal IPJ lesions often improve when using plantar fitted devices when the principal aeteological factors are retracted or clawed toes and ill-fitting shoes. Especially those cases where footwear hasn't been changed!
  17. wdd

    wdd Well-Known Member

    While I was thinking about straightening toes I went online and looked at photos of splints for broken fingers. Although I am not suggesting that anything in the photos is necessarily directly applicable I get the sense that more thought, effort and possibly money has been put into solving the problem of splinting broken fingers than has been put into straightening deformed toes. Students started using silicone about fifty years ago and the therapy seems to have stopped there?

    Straightening toes is largely concerned with the application of Wolff's and Davis' laws. I would think that identifiying the time dedicated to studying these laws in the undergraduate curriculum might give a good indicator of why non-surgical therapy has stagnated. Add on to that the problem of trying to alter the phasic activity of muscles and it's easy to see why surgery becomes the treatment of choice almost an easy option.

    Putting my Blue Peter hat on and using a length of elastic band and some superglue (tissue adhesive) to mimic the action of the digital extensors and the lumbricals and possibly a few other muscles unknown to man I think it would be possible to begin the process of straightening a toe without even thinking about silicone.

    In fact I'm going to give it a go and will post a photo or two later. I am not sure I can find a deformed toe but I am certain that I can stick some elastic band to a toe and make that toe assume some interesting positions for starters.

  18. Boots n all

    Boots n all Well-Known Member

    Toe spreaders like everything have their place, some of my arthritic clients love them as they stop the hallux rubbing the other toes, but they are not for everyone

    Please dont supply them to clients with diabetes, had one in last week, not good, not good at all, the more l look at the pic in his file the more l shake my head in disbelief
  19. In my post-surgical patients, I do find that using a toe spacer, between the hallux and 2nd digit, worn in the 3-6 months following bunion/HAV surgery, seems to result in better hallux correction within the transverse plane over time. Certainly makes sense that reducing tension on the medial collateral ligament during the healing period may allow this ligament to heal shorter versus being stretched excessively in the post-op period.

    Like I said before, there are uses for mechanical devices such as these, but they do have significant limitations in their ability to correct chronic digital deformities.

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