Toe spacers are a useful tool for anyone whose feet spend a great deal of time scrunched inside shoes.
While they aren’t a miracle cure for major foot problems, toe spacers can help stretch out and realign toes that are beginning an inward compression. They can prevent toes from drifting out of order and offer recovery after wearing constricting shoes. And they can hold toes in the correct position for patients doing rehabilitation to prevent or recover after surgery.
Toes that are straight, spread, and flat are normal for foot physiology but those traits often vanish in feet constantly in shoes that are narrow, rigid, overly structured, or have an incline. Toes may not seem like that big of a deal, but they’re connected to the body’s muscular, nervous, and circulatory systems. They constantly read and respond to sensory information that is foundational to the body’s operation.
“Separation of toes can help if used in the right way,” Dr. Paul Thompson said. “A big part of my practice is exercises based around stability and strength.”
To speed up healing, he often recommends toe spacers for patients to hold their feet and toes in the correct position while doing prescribed exercises. Toe spacers are usually made of silicon or gel and slide between the toes, stretching out not just muscles in the toes but the connective tissue holding together the entire foot.
Some podiatrists are recognizing the value of approaching toe deficiencies in a more holistic, gentler way using exercises and tools in place of the more traditional, invasive model of orthotic inserts and surgeries.
“The industry has gone down a path that’s more monetary based rather than looking at the whole person and how you can get them better,” Thompson said.
Who Needs Toe Spacers?
Podiatrist Dr. Emily Spilchal recommends toe spacers to about 95 percent of her patients.Because toe spacers are good for preventing foot problems, just about anyone could experience benefits from using them. Both Spilchal and Thompson regard foot education as an important part of their responsibilities.
Here are seven situations in which Spilchal says toe spacers can help:
(Spilchal doesn’t recommend a popular exercise of gripping and scrunching a towel with the toes. Even though it seems like it would strengthen smaller muscles, it actually trains the toes to curl under rather than to straighten into the preferred position that’s necessary for gait.)
“I try to create easy foot recovery techniques for patients that they can actually implement successfully,” she said.
“You always have to make sure you’re balancing stress with recovery,” Spilchal said.
“Balance exercises are really good for your feet because it requires them to contract and engage,” Spilchal said. “I want them to be done barefoot.”
Exercise Is Everything
Rehabilitation, though not easy, has more sticking power. When Thompson explains the benefits, he said most patients actually prefer it to surgery.“You have more control over your treatment rather than putting all your treatment in my hands,” he said. “I find if you take accountability and you understand what we’re trying to achieve, you get a better result, and it will last you longer.”
He recently saw a patient who previously had surgery to correct a bunion. Though his toes looked perfectly straight because of four screws, his foot was unable to move correctly and had functional problems.
“It might fix that particular issue, but if you aren’t looking at function ... it can lead to a lot of other problems as well,” Thompson said.
- Vertical “toe yoga”: Lift the big toe up while the other toes stay down and then lift the smaller toes while the big toe stays down. This engages toe and arch muscles.
- Horizontal “toe yoga”: Move the big toe out away from the other four toes.
- Short foot: Put equal weight on a triangle of points on the heel, the big toe pad and pinky toe pad. Then create an arch by gently pulling (but not curling) the toes toward the heel.
Spilchal said basic, easy exercises work best, done with bare feet.
She also said people should walk barefoot at least 30 minutes daily.
An Individual Approach
In addition to unlimited styles of shoes that influence foot development and functionality, how we spend our time, our anatomy, and the surfaces we walk and run on can impact foot health.Movement done on hard tile and concrete is less forgiving than walking on surfaces that are more natural, like wood and dirt.
Also, feet can become passive over time and degrade structures like tendons, nerves, and bones. The degree of insult can also influence the approach podiatrists take with rehabilitation. Even though barefoot therapy is critical, it can be too abrupt for someone with severe bunions and hammertoes. Better footwear and toe spacers may need to be introduced gradually.
Spilchal said variability of surfaces, in addition to foot posture, should all be taken into account in recovery.
“It’s an overly rigid foot that cannot withstand the pressure,” she said. “An otherwise neutral or sufficient foot should be able to meet the demands of movement without too much structure or support.”
Thompson, whose podiatry practice has evolved to offer workshops and preventative care products, changed his own views when the orthodox approach wasn’t working for his own feet.
“I couldn’t figure out why I couldn’t get my own feet better,” he said. “I tried lots of different pairs of orthotics, different shoes, and materials of orthotics.”
The relief was temporary until Thompson began to study the biomechanical issues of feet that weren’t taught in medical school. He realized he needed to stop wearing traditional shoes, even athletic sneakers because the heel is slightly raised and the toe box often curls up.
“They have features that are detrimental to how the foot functions,” he said. “That changes everything, how your muscles in your glute work. It changes the position of your calves, your ankles, and puts more pressure on your knees.”
Now you can find him hiking with his young children barefoot—unless the location might be dangerous. When they wear shoes, they are flat, flexible, and have a wide toe box.