Author - Anastasia Belikov, PT, Cert. MDT
Graduated with her DPT in 2017
Understanding the Big Toe
IN THE KNOW
Friday, May 19, 2023
The human foot is a marvel of engineering, comprising numerous intricate structures that work together to provide stability, balance, and efficient locomotion. One critical component of the foot is the hallux metatarsophalangeal (MTP) joint, commonly known as the big toe joint,or the joint that creates the ball of your foot. In this article, we will explore the structure of the hallux MTP joint and delve into the forces it experiences during walking.
The hallux MTP joint is situated at the base of the big toe, where the metatarsal bone (foot) meets the proximal phalanx (toe). It is a hinge joint, allowing movement primarily in one plane, enabling extension (upward movement) and flexion (downward movement) of the toe. The joint is supported by an intricate arrangement of ligaments, tendons, muscles, and surrounding tissues. The primary ligaments of the hallux metatarsophalangeal joint include the collateral, plantar and deep transverse metatarsal ligaments. These structures provide stability and prevent excessive movement or dislocation of the joint during weight-bearing activities.
Walking is a dynamic process that involves the transfer of forces throughout the foot. The forces acting on the big toe MTP joint can be categorized into compression forces and shear forces.
Compression forces: When we walk, the body weight is distributed across the foot. As the foot strikes the ground, the force exerted on the big toe MTP joint increases. This force is transmitted through the bones, tendons, and ligaments of the joint. Proper alignment and stability of the joint are crucial to absorb and distribute these forces efficiently.
Shear forces: During the push-off phase of walking, the hallux MTP joint experiences shear forces. These forces are a result of the ground reaction force pushing the big toe upwards as the foot propels forward. The flexor and extensor tendons play a vital role in controlling these shear forces and maintaining joint stability.
Several factors can contribute to abnormalities or conditions affecting the big toe MTP joint. Some common issues include:
Hallux valgus: This condition, commonly known as a bunion, involves the deviation of the big toe towards the other toes. It can lead to joint misalignment and instability, causing discomfort and pain during walking.
Hallux rigidus: Hallux rigidus is characterized by the progressive degeneration of the joint, resulting in stiffness and limited range of motion. Individuals with this condition often experience pain and difficulty when walking, particularly during push-off.
Turf toe: This injury occurs when the hallux metatarsophalangeal joint is hyperextended, typically due to sudden forceful movements. It can result in ligament sprains, pain, and limited joint function.
The hallux metatarsophalangeal joint plays a crucial role in maintaining balance, stability, and efficient propulsion during walking. Its complex structure and the forces it encounters emphasize the importance of maintaining joint health and addressing any abnormalities or conditions promptly. By understanding the structure and forces acting on this joint, we can appreciate the significance of proper foot care, footwear choices, and biomechanical considerations to support optimal foot function and overall well-being.