Ask the podiatrist: My big toe won’t stay flat

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Karrianne says: My big toe has often not wanted to be flat in my running shoe, or even when barefoot around the house. It's really bizarre, I can feel it when it's lifting up but it isn't painful.

Hi Karrianne, this sounds like a muscle that lifts up your big toe (and also lifts your foot up at the ankle joint to a lesser extent) – the muscle extensor hallucis longus (EHL). It may be compensating for a weakened muscle on the front of your shin – the muscle tibialis anterior (TA). Muscle TA is responsible for a) lifting your foot at the ankle joint before it strikes the ground at each step and b) slowing the speed at which the foot lowers to the floor once the heel has struck the ground. Muscle TA can weaken for a number of reasons, but two common training reasons are incorporating more downhill work in your training regime and lacing your footwear too tightly, compressing the tendon of muscle TA under the shoe’s tongue.  Once muscle TA has weakened then muscle EHL will substitute for it performing similar functions. Muscle EHL, however, will be required to contract harder and for longer than it would normally do with the result of a big toe that raises from the ground both in and out of footwear.

Reduce any downhill work in your training regime and revise your lacing strength. Consult with a podiatrist or physiotherapist who specialises in sport-related injuries or a sports injury therapist for muscle TA rehabilitation techniques if symptoms persist.

Michael Ratcliffe is a podiatrist and advisor for Carnation Footcare.