Recurring pain in a toe or toes, which may feel like a cramp, can be related to an aberrant gait cycle. When a patient presents with this complaint, I watch them walk.
Commonly, during toe-off, when the weight-bearing foot is rolling forward as the heel of the opposite foot takes the body’s weight, the toes on the “rolling” foot are "pushing." This not only assists in balance, but helps propel the walker forward.
If this action of the toes is unnecessarily strong, toe pain, either from stress on the joints or overly-contracted muscles, can be the result. This is common with vigorous walkers or “power” walkers.
Shoes that are too stiff can also be part of the problem. The walker must work harder during the gait cycle to overcome a stiff shoe.
When a patient has this toe pain, I adjust the lower extremities, with careful attention to the feet and toes. then advise about proper walking shoes. I show the patient how to moderate their gait to help this condition resolve.
