Significance of free-dorsiflexion of the toes in walking.

Abstract

Dissection reveals that the ball of the foot contains a connective tissue framework with transverse, vertical, and sagittal fibers, all connecting the skin with the proximal phalanges of the toes. Dorsiflexion of the toes tightens the framework and thereby restricts passive movements of the skin, enabling shear forces to be transferred to the skeleton. An electromechanical oscillator was constructed that applied oscillatory shear forces of constant amplitude (+/- 0.2 N) to the skin and at the same time measured the resulting motions. It was found that the toes should be dorsiflexed by 35--40 degrees to restrict skin mobility to 50 per cent and by 50 degrees to restrict it maximally. The results were compared to actual dorsiflexions of toes during walking. These dorsiflexions were measured on slow motion film and with still pictures with light tracks formed by light emitting diodes. Maximal dorsiflexion during push off was found to be 60 degrees for feet walking without shoes, 45--50 degrees for feet walking in soft shoes, and 25--30 degrees for feet walking in a stiff shoe of the minus-heel type. Dorsiflexion was further found significant for arch support and for the mechanics of the forefoot during push-off.