Altra Toe Box

The Importance of a Roomy Toe Box

By Dr. Courtney Conley, DC, Founder of Gait Happens

December 20, 2024

 

Did you know that the widest part of our feet should be our toes? Many sources would say it’s the ball of the foot, the width from the first metatarsal to the fifth metatarsal. However, if our feet are in proper alignment, this width should extend into our toes allowing for toe splay. There are many reasons why this is the natural position for our feet, and why we need to respect and allow for this anatomy.

 

What is toe splay?

First, what exactly is toe splay? Toe splay refers to the natural spreading or separation of the toes. This splay allows for better balance and stability while standing, walking, or running. It also helps to distribute body weight more evenly across the foot and provides better grip and traction on uneven surfaces. Think about this. If you were trying to balance, walk, or run with a rubber band wrapped around your toes, would it be more or less difficult than being able to have your toes splay? This is not a trick question, the benefits of letting your toes splay is just that simple.

 

Why is toe splaying important?

Toe splaying is essential for athletic performance as well as normal day-to-day activities. Our feet go under an immense amount of load with walking and running. When walking, the forefoot typically bears around 33% to 40% of the body weight with each step (1). This percentage can increase when walking at faster speeds or when walking uphill, as more force is exerted on the forefoot to propel the body forward. During running, the load on the forefoot can be even greater. In a forefoot or midfoot strike pattern (where the initial contact is made with the front or middle of the foot), the forefoot bears the majority of the impact force generated by the body's forward motion. Studies have shown that the forefoot can experience forces of 8x our body weight during running (2). This load is comparable if not more for activities such as sprinting or jumping. So, let’s revisit our rubber band question. Do you think having a wide, stable forefoot would be better at handling these loads or one that is squeezed together? Again, not a trick question, it’s just that simple.

 

How does splaying our toes make us more stable?

There is a beautiful mechanism in the foot that helps create this stability—it’s called the tie bar mechanism. The human foot has 3 primary arches. The medial and lateral longitudinal arches which run lengthwise from heel to toe and the transverse arch which runs side to side. These arches are formed and controlled by the bones, ligaments, and muscles of the foot.

When we are walking and running, weight is applied to the foot. This weight causes these arches to compress and lower slightly. This is how our feet should work! This is what we refer to as pronation. Pronation is our first opportunity for shock absorption when we are moving. The arch should feel like it is lengthening and widening. This is NOT a movement we want to try to block or avoid.

When the foot pronates, this lowering causes the foot to splay. This splaying of toes is controlled by the ligaments and tendons that form the tie bar. It is this tie bar that helps maintain the stability and shape of the arches.

The tiebar mechanism plays a crucial role in distributing forces evenly across the foot, absorbing shock, and providing stability and propulsion during locomotion.

If restrictive footwear does not allow this natural toe splay, dysfunction or weakness in the tie bar mechanism can occur. This can lead to conditions such as flat feet (pes planus) or excessive pronation, which may lead to foot pain, instability, and increased risk of injury.

We’ve now discussed the many benefits of allowing our toes to splay. So, what prevents this toe splay from occurring and why would we ever want to do that? Great question.

Let’s start with the biggest culprit, our footwear. The majority of shoes available to the consumer are not foot shaped. In fact, they actually do quite the opposite. The toe box is narrow, squeezing the toes into a tapered position–just like our rubber band analogy. Our toes are constantly being squeezed together. As we’ve noted, this can have a detrimental effect on the strength and stability of our feet. By restricting proper toe splay, these shoes can affect our balance, our gait, and our movement efficiency.

The old adage, “if you don’t use it, you will lose it” most certainly applies to our feet. If we don’t use the muscles in our feet, we will lose the strength of these muscles. When our toes are unable to splay in our footwear, muscles like abductor hallucis (abducts or helps to straighten the big toe) and abductor digiti minimi (abducts or helps to straighten the little toe) are unable to function appropriately. When their function is compromised, weakness ensues. Considering these muscles play a significant role in our ability to balance, we do not want to discourage splayed toes and lose this function.
 
The other concern with weakness of these muscles is the development of bunions or other forefoot deformities. When toes are not allowed to splay after years of restrictive footwear, the integrity of our foot changes and it is this type of footwear that research will show us contributes to the development of bunions (3–6). Of note, those of us with bunions and hammertoes have a greater risk of falling as we age as our forefoot stability is now compromised.

Many reading this article will already have developed forefoot deformities such as bunions, hammertoes, neuromas etc. This is why selecting footwear that allows splayed toes is a non-negotiable. Any constricting toe box will place additional tension on the foot and can cause significant pain and discomfort.

 

What are the options for healthy footwear?

First, let’s get clear on terminology. There is a difference between a wide toe box and a wide shoe. Most shoe companies will try to accommodate for the ‘width’ of our feet, however, the width does not extend into the toes. Therefore, regardless of how wide the shoe is, if the toe box is tapered, it will not allow normal toe splay.

Altra has been one of the few companies to respect the natural development of our feet. Their concept of a roomy toe box allows for the necessary toe splay making their shoes some of the most comfortable shoes on the market for both walkers and runners.
 

I personally have been running in Altra’s for the past 7 years and find them to be some of the best shoes for toe splay. I specifically have put my patients with foot pain and dysfunction in shoes with the original FootShape Fit, like the Lone Peak and Olympus, as it allows for proper function of the foot. Models such as the Escalante Racer, have also been very successful with our patient population as the upper of the shoe is made of a mesh material allowing for significant toe splay.

 

In conclusion, allowing the foot to be in its natural position with toes splayed is mandatory. If we are to ensure proper foot strength and function, maintain our balance and eliminate pain, we have to start paying attention to our feet. If our goal as human beings is to be able to walk and move well into our later years, we must pay attention from the ground up. This starts by building the health of our feet and the lowest hanging fruit my friends, is simply to wear a shoe that fits.

 

References:
1. Jacob, H.A.C. (2001). Forces acting in the forefoot during normal gait - An estimate. Clinical biomechanics (Bristol, Avon). 16. 783-92. 10.1016/S0268-0033(01)00070-5.
2. Dorn T, Schache A, Pandy M. Muscular strategy shift in human running: Dependence of running speed on hip and ankle muscle performance. J Exp Biol. 2012;215:1944-1956.
3. Wyderka M, Gronowska T, Szeląg E: The crooked foot and the quality of life. Polish Nursing. 2013; 49: 169– 75.
4. Puszczałowska-Lizis E, Dąbrowiecki D, Jandziś S, Żak M. Foot deformities in women are associated with wearing high-heeled shoes. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research. 2019;25:7746.
5. Dufour A, Broe K, Nguyen U, et al. Foot pain: is current or past shoe wear a factor? Arth Rheum. 2009;61:1352-1358.
6. Zipfel B, Berger L. Shod versus unshod: the emergence of forefoot pathology in modern humans. Foot. 2007;17:205-213.