#toe flexion

We all read about ankle rocker and, when it is impaired, how it can wreak havoc on sagittal foot-ankle and gait mechanics. When ankle rocker/dorsiflexion is limited, moving our body mass forward over the foot-ankle complex can be a challenge because we have to compensate elsewhere to move forward (putting loads in places we do not want them, or working harder in areas we don't wish to be working so hard). This study below suggests a linkage between the toes and ankle range of motion. The study "characterized the effects of varying toe joint stiffness across a range of different ankle joint stiffness conditions, and the effects of varying toe shape on walking biomechanics. " As we eluded to above, the study suggests "To our surprise, we found that varying toe joint stiffness affected COM Push-off dynamics during walking as much as, or in some cases even more than, varying ankle joint stiffness. Increasing toe joint stiffness increased COM Push-off work by up to 48% (6 J), and prosthetic ankle-foot Push-off work by up to 181% (12 J)." Follow this thought experiment: 1. So, yesterday. (Oct. 15, 2018) we proposed a thought that increased toe flexion loads during stance phase loading can impact normal metatarsophalangeal (MTP) dorsiflexion. One will find it a biomechanical challenge to extend the toe when the flexors are trying to flex (yes, eccentric contractions thus come into play in this thought experiment but here today we are referring to those who over grip/clench into toe flexion for one of a myriad of mechanical reasons we will not discuss here today). 2. Note, MTP dorsiflexion (ie, extension) is what happens at the end of ankle rocker and progression thus into heel rise. 3. Heel rise encompasses posterior compartment engagement, in which studies suggest that up to 50% of propulsion comes from the calf-posterior compartment. 4. This study today said that "varying toe joint stiffness affected COM Push-off dynamics during walking as much as, or in some cases even more than, varying ankle joint stiffness. Increasing toe joint stiffness increased COM Push-off work by up to 48% (6 J), and prosthetic anklefoot Push-off work by up to 181% (12 J)." 5. So, is it possible to suggest that plastic changes in flexor tissues, capsule, and ligaments impair MTP function, thus impairing ankle rocker, thus demanding more, and premature calf complex loading work up to 48%? Do you have a client with toe gripping and to flexion overdrive? Do they also have a loss of ankle rocker/dorsiflexion? Loss of hip extension and gluteal activity? Low back pain? After. all, we are just moving up the posterior chain, . . . we like to say, . . . . the load has to go somewhere and the work will have to be done somewhere. http://iopscience.iop.org/article/10.1088/1748-3190/aadf46