Injured Toe Joints

By Ben Benjamin, PhD

Question: Which toe joint is most often injured, and why?

Answer: The proximal joint of the great toe.

The proximal great toe joint is the most often injured toe joint, primarily because it is frequently called on to support more weight than it is designed to support.

In the normal foot, two-sixths of the weight that passes through the foot falls onto the great toe joint at the proximal end of the first metatarsal; one-sixth falls on each of the other four joints. If you look at the calluses on the bottom of many peoples' feet, you will notice that the largest and toughest calluses are often under the great toe. This means that too much weight is being placed on the medial aspect of the foot, due to structural abnormalities and/or excessive foot pronation. If this situation exists and the individual is athletic, or stands or walks a great deal, continual stress is placed on this joint, making it very prone to injury. It is an especially common injury for those who dance, run or play soccer.

For example, let's assume that the person has some degree of abnormal pronation of the foot, and that half of the body's weight falls onto the great toe, instead of one third. This means that the impact of every step, run and jolt falls disproportionately on the great toe. Imagine walking or jumping up and down on your hands, with your wrists extended; it would not take long before your wrists would ache from multiple injury. The foot is designed to spread out the weight of impact such that excessive strain does not fall on one part of the foot. When this uneven distribution of weight occurs, injury to the great toe joint is often the result.