Toe spread exercises for mild hallux valgus

NewsBot · May 4, 2013

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Comparison of muscle activities of abductor hallucis and adductor hallucis between the short foot and toe-spread-out exercises in subjects with mild hallux valgus.
Kim MH, Kwon OY, Kim SH, Jung DY.
J Back Musculoskelet Rehabil. 2013 Jan 1;26(2):163-8.

BACKGROUND AND OBJECTIVE:
Muscle imbalance between the abductor hallucis (AbdH) and adductor hallucis (AddH) has been demonstrated in hallux valgus (HV). Clinically, the short-foot (SF) is performed for strengthening foot intrinsic muscle. The toes-spread-out (TSO), the newly introduced, was devised to correct HV deformity. However, there was no study to determine which exercise is effective in balancing the ratio of activation between AbdH and AddH muscles. The purpose of this study was to compare the muscle activities of the AbdH and AddH between SF and TSO exercises in subjects with mild HV.

METHODS:
Eighteen subjects with mild HV participated. The muscle activity of AbdH and AddH and the angle of first metatarsophalangeal (MTP) joint in the horizontal plane were measured during the SF and TSO exercises. Values of dependent variables were compared using a paired t-test between the SF and TSO exercises.

RESULTS:
The TSO exercise showed significantly greater activation of the AbdH than did the SF exercise (mean difference=44.96% of maximum voluntary isometric contraction; p< 0.001). There was no significant difference between the SF and TSO exercises in activating the AddH (mean difference=8.28% of maximum voluntary isometric contraction; p=0.271). The ratio of AbdH to AddH muscle activity was significantly higher in the TSO exercise than in the SF exercise (mean difference=0.54; p=0.001). The angle of the first MTP joint in the horizontal plane during the TSO was significantly greater than that in the SF exercise (mean difference=9.60°; p<0.001).

CONCLUSIONS:
These results suggest that the TSO exercise can be recommended for preventing or correcting HV deformity at an early stage.
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Suzannethefoot · May 7, 2013

It's good to now what we are recommending actually works! :)

Zac · May 8, 2013

What are these exercises?

Sicknote · Sep 22, 2016

Zac said: ↑

What are these exercises?
Click to expand...

Easier said than done.

NewsBot · Jun 7, 2016

Treatment of Progressive First MTP Hallux Valgus Deformity: A Biomechanically-Based Muscle Strengthening Approach
Ward M. Glasoe, PT, PhD, ATC
J Orthop Sports Phys Ther, Epub 6 Jun 2016. doi:10.2519/jospt.2016.6704

Hallux valgus is a progressive deformity of the first metatarsophalangeal joint that changes the anatomy and biomechanical behaviors of the foot. To date, surgery is the only treatment that corrects deformity, though the recurrence rate is as high as 15 percent. This review instructs a strengthening approach for treatment, with the moment actions of five muscles identified as having the ability to counter the hallux valgus process. Unlike surgery, muscle strengthening will not correct the deformity but instead, the exercise may reduce pain and the associated gait impairments which, in turn, may improve the mobility of people who live with the disorder. This review is organized in 4 parts. Part 1 defines the terms of foot motion and posture. Part 2 details the anatomy and biomechanics, and describes how the foot is changed with deformity. Part 3 details the muscles targeted for strengthening. The intrinsics are the abductor hallucis, adductor hallucis, and the flexor hallucis brevis. The extrinsics are the tibialis posterior and fibularis longus. Part 4 instructs the exercise and reviews the related literature. Instructions are given for the short-foot, the toe-spread-out, and the heel-raise exercises. The routine may be performed by almost anyone at home, and could be adopted into physical therapist practice with intent to strengthen the foot muscles as an adjunct to almost any protocol of care, but especially for the treatment of hallux valgus deformity.
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NewsBot · Aug 24, 2016

Treatment of Progressive First Metatarsophalangeal Hallux Valgus Deformity: A Biomechanically Based Muscle-Strengthening Approach
Authors: Ward M. Glasoe, PT, PhD, ATC
J Orthop Sports Phys Ther 2016;46(7):596–605

Hallux valgus is a progressive deformity of the first metatarsophalangeal joint that changes the anatomy and biomechanics of the foot. To date, surgery is the only treatment to correct this deformity, though the recurrence rate is as high as 15%. This clinical commentary provides instruction in a strengthening approach for treatment of hallux valgus deformity, by addressing the moment actions of 5 muscles identified as having the ability to counter the hallux valgus process. Unlike surgery, muscle strengthening does not correct the deformity, but, instead, reduces the pain and associated gait impairments that affect the mobility of people who live with the disorder. This review is organized in 4 parts. Part 1 defines the terms of foot motion and posture. Part 2 details the anatomy and biomechanics, and describes how the foot is changed with deformity. Part 3 details the muscles targeted for strengthening; the intrinsics being the abductor hallucis, adductor hallucis, and the flexor hallucis brevis; the extrinsics being the tibialis posterior and fibularis longus. Part 4 instructs the exercise and reviews the related literature. Instructions are given for the short-foot, the toe-spread-out, and the heel-raise exercises. The routine may be performed by almost anyone at home and may be adopted into physical therapist practice, with intent to strengthen the foot muscles as an adjunct to almost any protocol of care, but especially for the treatment of hallux valgus deformity.
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Dieter Fellner · Aug 25, 2016

NewsBot said: ↑

Comparison of muscle activities of abductor hallucis and adductor hallucis between the short foot and toe-spread-out exercises in subjects with mild hallux valgus.
Kim MH, Kwon OY, Kim SH, Jung DY.
J Back Musculoskelet Rehabil. 2013 Jan 1;26(2):163-8.
Click to expand...

Let's not be too hasty here .... has anyone read the full article? I am not about to spend E27.50 to do so.

From the abstract, all that can be deduced is that one exercise activates muscles more than another. The authors seem to extrapolate that such activity can prevent or improve early hallux valgus.

That's a big leap of faith!

NewsBot · Feb 6, 2018

This clinical trial was just registered:
The Toe-spread-out Exercise in Patients With Hallux Valgus and Without the Deformity

The effectiveness of conservative treatment of hallux valgus deformity has not been sufficiently explored yet. The aim of this study was to assess the effect of the toe-spread-out exercise on the amplitude and frequency pattern in a surface electromyographic examination in patients with hallux valgus and in people without the deformity. An additional objective is the assessment of nerve conduction in an electroneurography and the assessment of range of motion in a clinical examination.
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