Why the hallux isn't touching the floor and how to fix it

50% of weight bearing through the toes should occur in the hallux aka. big toe. It is an integral structure for balance and gait. When it is not articulating with the floor it can lead to; balance deficits,  falling and gait abnormalities/inefficiencies.

Try standing on one foot then try again while lifting your big toe off of the ground.

I have had several patients with this problem and the way to solve it is to determine if it is due to a structural dysfunction, an anatomical structure that is blocking motion, or a non structural dysfunction. To review non-structural dysfunctions can be due to:

1. Inflammation
2. Alignment
3. Severe Atrophy
4. Upper Motor Neuron Disease or Injury
5. Lower Motor Neuron Disease or Injury

If it is a structural dysfunction, there are several ways to determine what structures are causing the hallux to be stuck in extension.

1. Palpate up the kinetic chain: If a anatomical structure is malalgined it is usually due to forces acting on that structure from its base of supports. Palpating the 1st, metetarsal, medial cunniforms, navicular, talus, and calcaneus for restrictions in the tissues should reveal the cause of the hallux extension.

2. Reposition, Release, and Re educate: Meaning put the toe in the position it should be and see and feel for structural restrictions up the kinetic chain. Then release those and re educate.

3. Diagnostic Motion Evaluation: Doing foot clocks or having the patient perform other types of  movement over a stationary foot in the closed chain will revel dysfunctions at the location of compensation or disjointed motion. This can be done in standing, sitting or hook lying.

The observer must watch for the following; 
a. When and where the motion stops or is no longer sequential or evenly distributed.
b. When the patient compensates for the motion, in the case of the foot the compensation is usually the sole of the foot coming off of the floor.