Toe spread test
- Fysiobasen
- Oct 2
- 3 min read
The Toe Spread Test is used to evaluate flexibility, mobility, and strength of the intrinsic foot muscles, which are responsible for toe movements and stability. The test provides valuable insights into overall foot function, balance, and muscular coordination, and it is often applied to identify:
Muscle imbalances in the foot
Effects of footwear and orthoses on foot performance
Risk factors for plantar fasciitis, hallux valgus (bunions), and flatfoot [1]
Coordination and activation of intrinsic foot muscles essential for posture and balance [2][3]
Test Procedure
Patient position
The patient sits comfortably with both feet flat on the ground.
Alternatively, the legs may be stretched out in front if preferred.
Starting position
Feet in a neutral position, toes pointing forward.
Execution
The patient is instructed to spread their toes as widely as possible, emphasizing separation of the hallux from the lesser toes and spreading of the smaller toes from each other.
Observation
Examiner evaluates movement range, symmetry, and control.
Ideally, toes should spread evenly with a slight lift of the medial arch.
Inability to spread toes may indicate weakness or poor activation of the intrinsic foot muscles.
Variation
Can be performed unilaterally to assess asymmetries or localized dysfunction [4].
Evidence and Clinical Significance
Toe spreading and foot health
Strong intrinsic foot muscle activation is linked with improved posture, balance, and foot alignment.
Reduced toe spread is associated with weakened intrinsic muscles, altered gait, and decreased stability [6].
Foot disorders
Flatfoot, plantar fasciitis, and hallux valgus often present with reduced toe spread capability [7].
Hallux valgus especially restricts abduction of the hallux, limiting toe separation.
Biomechanics and performance
Adequate toe mobility supports efficient push-off and stabilization during walking and running.
Toe spreading ability contributes to injury prevention and improved load distribution [8][4].
Footwear and toe mobility
Narrow toe-box shoes can restrict toe movement and weaken intrinsic foot muscles over time.
Barefoot activities and minimalist footwear have been shown to enhance toe mobility and muscular activation [8].
Conclusion
The Toe Spread Test is a simple and effective clinical tool to assess foot mobility, intrinsic muscle strength, and functional performance. It can help identify muscle imbalances, deformities, and biomechanical abnormalities that may contribute to injury risk. For accurate assessment, it should be combined with other clinical evaluations and functional testing.
Sources
Fishkin MV, Fomenko MV, Schermann H, Haggai S. First clinical experience of a new surgical technique including correction of bony alignment of first foot ray combined with reconstruction of muscle balance in case of adolescent hallux valgus. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2021 Jul 9;9(2):183-93.
Okamura K, Egawa K, Okii A, Oki S, Kanai S. Intrinsic foot muscle strengthening exercises with electromyographic biofeedback achieve increased toe flexor strength in older adults: A pilot randomized controlled trial. Clinical Biomechanics. 2020 Dec 1;80:105187.
Rodríguez-Sanz D, Tovaruela-Carrión N, López-López D, Palomo-López P, Romero-Morales C, Navarro-Flores E, Calvo-Lobo C. Foot disorders in the elderly: A mini-review. Disease-a-Month. 2018 Mar 1;64(3):64-91.
Gooding TM, Feger MA, Hart JM, Hertel J. Intrinsic foot muscle activation during specific exercises: a T2 time magnetic resonance imaging study. Journal of athletic training. 2016 Aug 1;51(8):644-50.
@tomohalloran.Teo Spread Test. Available from: https://youtube.com/shorts/AvnQAgjaz6k?si=PlwYxywcOADaDIyz [last accessed 6/6/2023]
Fraser JJ, Hertel J. Effects of a 4-week intrinsic foot muscle exercise program on motor function: a preliminary randomized control trial. Journal of sport rehabilitation. 2019 May 1;28(4):339-49.
Kobayashi T, Hirota K, Otsuki R, Onodera J, Kodesho T, Taniguchi K. Morphological and mechanical characteristics of the intrinsic and extrinsic foot muscles under loading in individuals with flat feet. Gait & Posture. 2024 Feb 1;108:15-21.
Cucuzzella M. Pediatric Footwear. Athletic Footwear and Orthoses in Sports Medicine. 2017:433-40.
