A year ago I partially severed and crushed the big toe of my left foot and had surgery to pin and stitch it. I was told full recovery would take a year and that my big toe would be stiff, but otherwise not to expect any long-term problems.
Having done extensive bodywork, I felt my body was in a good place and wouldn’t be significantly affected by this injury – how wrong could I be?
Following a successful surgical outcome and returning to work four weeks after the incident, it soon became apparent that all was not well. I was experiencing knee pain, my pelvis had become rotated and lower back pain followed. The road to full recovery has been long and slow but my salvation has been my knowledge of Method Putkisto. As that first anniversary approaches, I thought it timely to share my experience in this blog, in the hope it will help you to ‘think outside the box’ when it comes to this and other ailments. It also makes me look less like a loopy person when you come to me suffering from back pain and I start twiddling your big toe.
Big Toe Facts
A foot and all its parts are sturdy enough to absorb the high impact of landing your bodyweight on the ground. Of all the toes, the big toe carries the most weight – about 40% of the load. It is also the last part of the foot to push off the ground before you take the next step and in order for this to happen your big toe must go into 45-60 degrees of extension (dorsiflexion).
So what happens if your big toe is stiff and can’t dorsiflex?
To keep you moving, your body tries to compensate for the lack of movement by shifting your body weight medially in an attempt to get your big toe to hit the ground. This is only the start of a whole chain of compensation:
- knee collapses inwards to get as much weight as possible on the big toe
- hip moves into internal rotation
- lumbar spine compensates by shifting towards the side of internal rotation
- resulting in muscle shortening impacting the joints of the spine, leading to degenerative changes
- resulting in back pain.
Without turning this blog into a complicated anatomy lesson, it suffices to say you have muscles to extend and flex the big toe; all of these muscles convert into tendons (thick fibrous bands) that attach to bones of the lower leg.
Imbalances between these muscles, or shortness which results in the muscles becoming restricted, can lead to loss of mobility or difficulties transferring weight from heel strike to the fifth toe to the first toe.
My injury had fractured bone and damaged both flexors and extensors. Post-operative immobilisation had resulted in me being in a dorsiflexed position for four weeks, add to that extensive scar tissue and it was entirely logical to expect restrictions.
At this point it is worth mentioning the role of the psoas, the only muscle that bridges the upper and lower body (dividing the weight of the upper body equally between the legs) and acting as a reservoir of unprocessed energy.
When you walk correctly the weight of the body falls on the big toe in order to push off to the next step; this activates the inner thigh and the psoas. Because the psoas is connected to the lumbar spine, misalignment of the pelvis, legs and in turn the psoas impacts the spine.
The easiest way to feel the connection between the psoas and big toe is to stand with feet parallel, hip distance apart.
- roll your weight onto the outside of your feet and you’ll feel the outer thighs engage; your inner thighs lose tone.
- Roll your weight onto the inner edge of your foot and your big toe and you’ll feel the inner thighs tone slightly.
The importance of this weight shift, this grounding or rather in my case the lack of it (my inability to bear the weight of my upper body through my centre) played a significant role in my back pain.
Journey to Recovery
Short term I required the care of my orthopaedic surgeon, osteopath and physiotherapist. However these specialists could only guide me at the start of my journey to recovery.
Long-term resolution lay in formulating an extensive programme of local (foot and leg) and global (core and spine) care using exercises from the Method Putkisto repertoire. I will eternally be grateful to Marja Putkisto, founder of the Method, who provided guidance in several 1-2-1 sessions and helped me out of many a blind alley:
- Get to know your body
- Learn to feel and respond
- Do not accept anyone telling you everything is OK, if you do not feel OK
- Good nutrition and hydration are key to recovery
- Mobilise your joints
- Practice self-massage to improve blood and lymph flow
- Stretch to restore muscle length and balance
- Incorporate deep stabilisation and strengthening into your workout
- regularly review your progress and adjust your programme