How To Reduce Injury Risk By Improving Big Toe Function

Eighty-five percent. That's how much of your foot's stability comes from a single joint: your big toe. And if you've spent your life in narrow, restrictive shoes, there's a real chance yours isn't doing its job. Two out of three runners show some degree of big toe dysfunction, as do a large percentage of the population in general, especially older folks. Almost none of us realize this root cause for many conditions. In this article, you’ll learn why this one joint might be the actual reason behind your knee pain, your hip pain, your lower back pain, and the "overpronation" everyone keeps blaming on the wrong thing. 

The big toe plays an incredibly important role in efficient walking and running mechanics, and in injury prevention. In particular, the big toe facilitates efficient pronation and triggers the activation of the gluteal muscles on every stride. Pronation is the natural inward and downward rotation of the foot and the flattening of the arch during the walking or running stride. Many runners erroneously believe pronation to be a bad thing, as it is often blamed as a driving cause of overuse injuries. Hence the marketing of "motion control" shoes touted as being able to control or limit pronation. The truth is that poorly regulated pronation due to poor foot functionality is a driving cause of overuse injuries, not the act of pronation itself. Pronation is an incredibly efficient mechanism that allows your foot to absorb shock, balance moving bodyweight, and harness elastic energy for the next stride. Without efficient pronation, you experience a highly inefficient distribution of impact forces throughout your lower extremities, leading to microtrauma, inflammation, and ultimately injury.

Lee Saxby is a well-known British running coach, biomechanist, and educator who is internationally recognized for his work in natural running mechanics, injury prevention, and footwear design. He explains that when the big toe is unstable during the propulsive phase of the running stride, runners exhibit "alternative movement patterns, such as overpronation or supination." Saxby, who has studied the mechanics of thousands of runners, estimates that the big toe provides roughly 85 percent of the stability in your entire foot. Sixty percent of runners are considered to be either "overpronators" or "supinators," which means they are either collapsing through the big toe because it is weak and unstable, or they are avoiding loading the big toe "because it is stiff and painful," explains Saxby.

In one analysis of around half a million runners, close to two-thirds showed some degree of big toe dysfunction, a condition called "runner's hallux." Runner's hallux, also known as hallux limitus (Latin for "limited big toe"), is a painful degenerative condition affecting the big toe joint (the first metatarsophalangeal joint, or MTP joint). It's characterized by a partial loss of flexibility where the toe cannot bend upward normally during the push-off phase of running. Hallux rigidus is a more advanced stage where the joint becomes completely stiff and rigid, often developing bone spurs (osteophytes) on top of the joint.

Restrictive shoe boxes are a driving cause of runner's hallux, because they inhibit the big toe's ability to move powerfully and dynamically through the walking or running gait pattern, and during other types of activity. Of course, hallux limitus and hallux rigidus are not limited to runners. They are also common among the general shoe-wearing population. Seniors are particularly vulnerable due to decades of wear and tear breaking down the cartilage that cushions the big toe joint, combined with a declining ability to repair that cartilage. This typically manifests as osteoarthritis, complete with the growth of large bone spurs on the MTP joint and other high-wear joints across the body.

For the big toe to thrive, it needs to be freed from the other toes. The mechanism behind this is worth understanding, because it explains why a weak, stiff big toe doesn't just cause foot problems; it compromises your entire walking and running gait. As the big toe plants and bends upward (dorsiflexion) during takeoff, it tightens the plantar fascia along the arch in what's called the windlass mechanism, a sailing term for winding a rope or cable around a spindle to increase tension, the same basic action used to haul up a ship's anchor.

That tension from the windlass mechanism doesn't stop at your foot. It travels up the leg and helps trigger your glutes, the largest and most powerful muscle group in your body, to fire and drive you forward. Tiger Woods once famously withdrew from a 2015 PGA Tour event in San Diego, explaining that his glutes "weren't activating." He caught grief for it in the golf media, but he understood something most runners don't: without that efficient chain of activation starting at the foot, you lose power and put more strain on everything above it, in his case his lower back.

When your big toe can't do its job, that entire chain breaks down, and the impact and instability that should have been absorbed and redirected end up somewhere else, in your knees, hips, or lower back. It shows up locally too, in the remarkably high rate of bunions, hammer toe, corns, and arthritis among people who've spent a lifetime in narrow, restrictive shoes, including plenty of elite athletes. A quick search for photos of the feet of runners and basketball players at the highest level turns up some genuinely alarming results. Check out LeBron James, Deion Sanders, or Usain Bolt: that's what happens to even the best when they jam their feet into restrictive shoes and play hard for years on end.

One running shoe manufacturer is promoting a shoe that claims to improve big toe functionality. It has a slightly wider toe box and high-tech, carbon fiber reinforcement strips that supposedly help the big toe generate more power during the running stride. The company deserves credit for acknowledging the importance of big toe functionality, but we at Peluva contend that there is better way for the big toe to thrive, which is barefoot-inspired footwear and lifestyle. Peluva's five individual toe slots allow your toes to operate independently and dynamically through multiple planes of motion, allowing for an authentic barefoot-inspired footwear experience. 

This isn't just about room to wiggle. Genuine toe splay lets the metatarsals spread under load to absorb impact, and independent toe articulation lets the big toe find and use its own range of motion instead of being dragged along by its neighbors. Of course, you have to progress carefully away from a lifetime in elevated, restrictive shoes and give your feet appropriate stimulation to improve functionality.

A simple drill can help you start to notice and improve big toe function. Try this: stand with your feet pelvis-width apart, weight on your heels, and try to lift just your big toe off the ground without moving the other toes. Don't let your hips sway to help. Most people find this surprisingly difficult the first time, which tells you something about how disconnected that joint has become. Think of it as a bicep curl for your big toe. Start doing this exercise for a minute here and there, such as when you’re watching TV. Over time, your brain and your big toe will become more mobile and functional.

By embracing a more natural approach to footwear and movement, you can restore the strength and functionality of your big toes, paving the way for healthier, more efficient pronation and ultimately enhancing your overall performance and well-being. At Peluva.com, you can download a free 88-page eBook titled The Definitive Guide to a Barefoot and Minimalist Shoe Lifestyle, or ask for a free print booklet with your shoe order.