Toes: Structure, Function & Diseases

The toes are the end sections of the foot. Normally, each foot has five toes. They support the walking movement.

What are toes?

They are the terminal members of the human foot. The term toe is called Digitus pedis in Latin which translates to “fingers of the foot”. A human usually has ten toes, making five on each foot. All toes have nails. Like the fingers, the toes also serve to provide mobility in movement. They allow fine motor movements, which are very important for stabilization, especially when walking. There are different foot shapes that form in the womb during the first weeks of pregnancy. In most cases, the big toe is the longest toe of the foot. In this case, it is called the Egyptian foot shape, which is the most common with about 44 percent. If the second toe is the longest, it is called the Greek form. This occurs in 36 percent of cases. If the toes of the foot are almost in line, it is the Roman form, which statistically accounts for about 20 percent of cases.

Anatomy and structure

In structure, the toe bones are similar to those of the fingers. They are numbered and referred to as follows: The big toe is called the hallux or digitus pedis I. It is located on the inside of the foot on both feet. The other four toes are distributed to the outside and are numbered with the Roman numerals II to V. The small toe takes the number II. The small toe takes here the digit V. Its epithet is digitus. Like the big thumb, the big toe has only two phalanges. These are called phalanges. The smaller four toes each have three phalanges. These are divided into the proximal phalanx, the middle phalanx and the distal phalanx. The proximal phalanges are connected to the metatarsal bone by a joint, which is called the metatarsophalangeal joint. There is also another joint between each phalanx. The middle one between the metatarsophalangeal joint and the middle phalanx is called the proximal interphalangeal joint, and the one between the middle phalanx and the distal phalangeal joint. The toe flexor muscles consist of short and long muscles. The long toe flexors are connected to the lower leg and are therefore called extrinsic muscles because they originate outside the foot. They have long tendons that extend behind the medial malleolus to the foot and on the sole of the foot to the toes. The short toe flexors are intrinsic muscles and are located in the midfoot and forefoot. Although small, the foot muscles must carry heavy loads. For example, the tendons of the long toe flexors bear between 36 and 52 percent of the body’s weight during walking. In this process, the toe flexors coordinate the distribution of the load on the forefoot and the sole of the foot.

Function and tasks

The toes ensure that a wide variety of movement is possible. Their flexibility allows fine motor locomotion, which is what makes many sports possible in the first place. If the toes of the foot move toward the ground, this is called flexion or plantar flexion. If the toes are extended towards the dorsum of the foot, this is called extension or dorsal extension. If the toes are spread, this is called abduction. If the toes are then pulled together, this is called adduction. The big toe is especially important for stability during running and other movements. It is the end point of biomechanical movement and ensures that the foot can make a rolling motion that absorbs the shock from running. Any acceleration also passes through this part of the body, because its push off from the ground means a redirection of energy that leads to an increase in speed. The interaction of muscles, tendons and joints enables complex movement sequences that would be inconceivable without the toes and thus especially the big one. This applies not only to running, but also to dancing, hopping and tapping.

Diseases and ailments

Regularly wearing shoes that are too tight can cause not only blisters, but also corns. Due to the pressure, cornification of the skin occurs, which can develop into a horny cone. If this presses on the bone, it is extremely painful. Special plasters or solutions containing salicyl can provide relief. In addition, it is advisable to wear other, that is, further footwear. If a toe permanently bends in the form of a claw, this is called hammer toe.The metatarsophalangeal joint is overstretched in this case. Mainly due to wrong footwear like high heels, the foot muscles change in an unhealthy way. Physiotherapy in conjunction with different footwear usually already helps. In severe cases, surgical correction must be performed. In the case of an ingrown toenail, the edge of the nail bores into the nail fold. This happens especially often in the big toe. It is caused by shoes that are too tight or by incorrect trimming of the toenails. The result is toe pain caused by inflammation. Warm foot baths in soapy water can soften the nail and reduce the inflammation. If there is no improvement, surgical intervention is necessary. Here, after local anesthesia, the doctor cuts a piece of the nail from the toe and cleans the wound. To advance the healing process, the foot must not be loaded for three days after surgery.