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I began looking into toe spacers as an application for the treatment of foot and heel conditions about 10 years ago when my practice transitioned to more of a foot-focused specialty.
Toe spacers are a tool that promotes healthy toe splay by separating the toes and helping to restore the natural position and function of the feet. We have spent most of our lives wearing conventional, modern shoes that taper at the toe. Overtime, cramming our feet into narrow toe boxes causes our toes to shift inward and the natural space between our toes is diminished. This leads to many foot and gait conditions.
Wearing toe spacers is like putting braces on your teeth. With consistent use, your toes begin to return to their more natural position.
After recommending toe spacers to my patients and seeing the consistent positive results, my conclusion is that toe spacers are an essential tool and I have included them in my protocols to rehabilitate plantar fasciitis, bunions, hammer toes, and even Achilles tendonosis.
Dr. Angela Walk
The Plantar Fasciitis Doc
Specializing in Foot & Gait Mechanics
What Do Toe Spacers Do?
Toe spacers are a tool that promotes healthy toe spreading during our gait by separating the toes. They help to restore the natural shape and function of the feet by fanning the toes out into a natural position.
Most of us have been wearing ill-fitting footwear that narrows at the toe since childhood. A lifetime of cramming our feet into tapered toe shoes causes the shape of our feet to deform into the shape of the pointed toe box.
Our toes begin to move inwards and the space between our toes diminish. This malposition causes restrictions in our feet and hinders normal circulation and alters our gait sequence.
The loss of circulation creates degeneration of the soft tissue and our feet become weak and the muscles begin to atrophy. This sets us up for many foot, heel and lower leg conditions.
The first step is to transition out of shoes that narrow at the toe. Healthy, functional footwear is widest at the toe and has no elevation of the heel. Correcting footwear is critical, but we can't stop there.
We have more work to do to correct the changes in our feet. This is why toe spacers are so essential in restoring foot health.
Toe spacers help to increase circulation, improve balance, and create stronger feet. Wearing toe spacers is like putting braces on your teeth. Over time, your toes begin to shift back to a more normal position.
If you wear toe spacers during physical activity such as yoga, running, weight training, and barefoot walking, you can further enhance the corrective benefits.
I recommend toe spacers to most all of my patients with plantar fasciitis, bunions, Achilles tendonitis, hammertoes, metatarsalgia, and Morton’s neuromas. I personally wear them daily for prevention!
The Damaging Effects Of Narrow Toe Shoes
The most common cause of foot conditions is wearing ill-fitting footwear. Most conventional footwear is narrow and tapered at the toe. This poor design feature shifts and compresses our toes and prevents our feet from functioning normally.
Our feet have 26 bones, 33 joints and over 100 muscles, tendons and ligaments.
The human foot is amazing and complex.
When our feet and toes cannot spread and splay as we walk and run, this incredible group of muscles, joints, and tendons can no longer work to support our arches and gait.
With long-term exposure to conventional shoes, the intrinsic muscles of our feet begin to weaken, our toes start to deform, and our muscles shorten and atrophy.
The solution is to transition into natural, functional footwear that is widest at the toe and has no heel elevation and to wear toe spacers to stretch and realign your toes.
Take a look at my complete list of Approved Shoes For Plantar Fasciitis here.
Can Toe Spacers Help Plantar Fasciitis?
Plantar Fasciitis is the most common cause of foot and heel pain. It involves a degeneration of the collagen fibers in the plantar fascia, a thick, fibrous band that runs from your heel to your forefoot.
Symptoms include pain at the inside portion of the heel that is worse after prolonged periods of rest and with the first steps in the morning.
One of the most common causes of plantar fasciitis is weakness of the intrinsic muscles of the feet. The primary cause of weakness of your arch muscles is wearing narrow toe shoes.
Wearing toe spacers is one of the easiest things you can do to begin to strengthen your feet and restore normal function to your feet to combat the symptoms of plantar fasciitis.
Can Toe Spacers Help Bunions?
A bunion is a painful bony bump that develops on the inside of the foot at the big toe joint. Bunions are often referred to as hallux valgus, a condition where the big toe drifts toward the smaller toes and the outside of the foot.
Many sufferers believe that bunion formation is hereditary in nature and they developed them because their mom or grandmother had them.
That may be true in very few cases, but this isn't the majority. This hereditary hypothesis has been proven in many studies.
The primary cause of bunions is wearing footwear that is tapered or narrowed at the toe. Your feet conform and deform to the shape of your ill-fitting footwear.
I began including toe spacers in my treatment protocols to correct bunion formation. With consistent efforts, many of my patients gained more normal positioning of the toes and much needed pain relief.
In a small 2018 study of 56 women with moderate bunions published in the Journal of the American Podiatric Medical Association found that a combination treatment of toe separators with foot mobilization exercises resulted in a significant reduction in bunion severity at the mark of one year of use.
Follow these steps to help correct your bunions:
Transitioning to functional, natural footwear with wide toe boxes and no elevation of the heel.
Wearing toe spacers to realign your toes to their natural position
Using resistance bands to strengthen the toes
Can Toes Spacers Help Hammer Toes?
A hammer toe is a deformity of the second, third or fourth toes. In this condition, there is an abnormal bend in the middle joint, so that it resembles a hammer.
Initially, hammer toes are flexible and can be corrected with simple measures but, if left untreated, they can become fixed and rigid.
This deformity can cause pain and difficulty walking, and a corn or callus may appear on top of the joint. Hammer toe is the result of a muscle imbalance that puts pressure on the toe tendons and joints.
Muscles work to straighten and bend the toes. If the toe is bent in one position long enough, the muscles and joints tighten and eventually lose the ability to straighten the toes.
Wearing shoes that narrow or taper at the toe or have an elevation of the heel is the most common cause. Narrow toed shoes force the toes to overlap and weaken the feet and and shoes with higher heels place stress on the forefoot and creates more bend in the toe.
Treatment includes transitioning to natural, functional footwear that is widest at the toe and no elevation of the heel and wearing toe spacers to correct the malposition of the toes.
Can Toe Spacers Help Achilles Tendonitis?
Achilles tendonitis and tendonosis are "overuse" disorders and are usually caused by a sudden increase of a repetitive activity involving the Achilles tendon.
Such activity puts too much stress on the tendon too quickly, leading to micro-tears to the soft tissues. The structure and function of the tendon is then altered and this creates pain and weakness.
The protocols I recommend for Achilles Tendinopathy include:
Transition to natural, functional footwear that has no elevation of the heel (zero-drop) and wide at the toe box. Heel elevation shortens the heel cord over-time. Functional footwear puts the calf and Achilles tendon back into their normal length.
Toe spacers will ensure proper toe alignment, optimizing circulation and encouraging balance.
Rest or reduction in activity
Progressive loading and strengthening of the heel cord with leaning calf raises
How Long Can You Wear Toe Spacers?
Wearing Toe Spacers for as little as 10 minutes a day can help to improve foot mobility and repair damage from wearing narrow toe box shoes.
I recommend starting with 10-15 minutes a day during passive activity while your sitting on the couch, reading, or watching Netflix.
Progress to wearing them longer periods of time as you feet adjust. Soreness can be expected in the beginning
Set a goal to wear your toe spacers for at least 2 hours a day.
If you wear them during physical activity while walking, running, yoga or weight training, it further amplifies the corrective benefits.
How Long Does It Take For Toe Spacers To Work?
If toe spacers are used consistently, a typical timeline might look like this:
Immediate ~ 1 Month: Improved foot/ankle strength and alignment. Mild pain is relieved. Soreness from initial use can be expected.
3 months ~ 1 Year: Increased toe flexibility and position. Greater pain relief is expected. Changes in bunions and hallux valgus positioning is noted.
6 months ~ 3 Years: Remarkable increase in toe/foot strength and noticeable changes in toe position. Significant pain relief.
Can I Wear Toe Spacers At Night?
Some people wear toe spacers to bed. Wearing them for this length of time can further increase circulation and correct toe malposition.
However, you must slowly progress to wearing toe spacers for this length of time. If you feet and toes have not been conditioned, soreness is expected.
I am an advocate of wearing toe spacers at night, however, to get the greatest benefit, wear them during weight bearing activities to further enhance their corrective benefits. Wear them while barefoot walking, yoga, weight training or hiking.
Can You Wear Toe Spacers Inside Your Shoes?
In order to get the greatest benefit from toe spacers, wear them inside your shoes during physical activity. Wear them while exercising or running, hiking or cycling.
You must wear shoes that have adequate space to accommodate your toe spacers. Below, find the necessary footwear criteria:
A wide toe box to encourage natural toe splay and spreading of the toes
A flexible sole to encourage enhanced foot strength
A completely flat support platform from heel to toe to encourage natural arch support
A thin sole that is not heavily cushioned
Our feet are inherently strong and do not need added arch support or extra cushion. It seems that the less “technology” a shoe has, the better it is for the foot. The more a shoe externally “supports” the feet, the less internal strength the the feet develop.
Wearing toe spacers in your wide toe box shoes consistently has shown to greatly improve foot strength and toe positioning.
Can I Wear Toe Spacers While Running?
An important tool to include in a runner's arsenal is toe spacers. Wearing toe spacers in your running shoes have many benefits.
Let's take a look at why I recommend toe spacers to all of my patients that are runners.
Improves circulation: toe spacers spread the toes and allows for proper circulation in the feet.
Increases strength: toe spacers can realign your toes to their normal, natural position and restores strength to the intrinsic muscles of the feet.
Reduced foot pain: toe spacers while running realigns your toes and gently stretches the muscles in the feet, helping relieve pain and tension.
Increased stability: Toe spreaders creating a wider and more stable base. Therefore providing better balance and stability.
Increases range of motion: toe spacers stretch the small muscles of the toes increases toe flexibility. Proper big toe flexibility can help prevent injury.
Better shock absorption: increased toe flexibility and range of motion helps activate the plantar fascia and our arch muscles. This increases our ability to absorb shock with each step.
The Benefits Of Barefoot Walking
The benefits of going barefoot are numerous. Barefoot walking has been shown to naturally increase the strength of your foot muscles, provide better balance, and even prevent foot conditions such as plantar fasciitis, bunions, and hammer toes.
Many studies have shown that barefoot cultures have fewer foot and knee problems. Physicians who performed the studies observed that people who lived barefoot, had significantly straighter, more aligned toes.
It takes time to train your feet to enjoy barefoot walking. You will need to slowly begin to introduce your feet to this new concept. Try to make a conscious effort to take your shoes off when you’re at your desk, or just walking around the house.
This is something that I have made a habit of doing daily to increase natural foot strength. Start with going barefoot for 30 minutes each day then increase each week.
Wearing toe spacers while walking barefoot further enhances the benefits.
Can I Treat Plantar Fasciitis At Home?
If you have this debilitating condition, here are my top 3 recommendations to get you started on your home rehabilitation.
1. Download my free guide. This is the first step on your PF recovery journey. I show you the exact steps to resolve plantar fasciitis at home.
2. Follow my social media pages. I offer daily tips, exercises, and the latest insights on PF. You can also connect and learn from others with the same struggles. Join us: Facebook page & Instagram
3. Take a look at my approved footwear guide. Dr. Angela's Recommended Shoe List and make sure you are not sabotaging your recovery by wearing the wrong shoes.
Because there is so much misinformation out there about plantar fasciitis, I spend most of my time educating people on what NOT to do.
Most rehabilitation efforts fail because they are relying on cortisone shots, night splints, orthotics, ineffective stretching, thick, cushiony shoes, and rolling on a frozen water bottle.
These methods are either ineffective or just short-term band-aids, and do not provide long-term correction.
In my (6) step free guide, I offer solutions through addressing multiple factors. Improving footwear, identifying areas of weakness in the foot and ankle, and restoring proper foot function.
Summary
After reviewing the research and experimenting with toe spacers with hundreds of patients with foot disorders, my conclusion is that toe spacers are an excellent tool to promote healthy toe positioning and increase the function of the feet. I'm sure you noticed in this article a recurring theme associated with each of the foot conditions mentioned. The most common cause of all of these conditions is wearing conventional, modern footwear that narrows or tapers at the toe.
Transitioning to natural, functional footwear is my first and most important recommendation followed by wearing toe spacers to correct the damage. Wearing toe spacers is one of the easiest methods to begin create healthy feet.
If you have additional questions about foot conditions, don’t hesitate to reach out. I'm here to help get you back on your feet--literally.
Best of Foot Health,
Dr. Angela
I have also written extensively on the topic of Plantar Fasciitis. Take a look at these other related blog posts:
I have been involved in the health and wellness industry for over 25 years as a wellness physician, sports chiropractor, and foot health coach.
I have written extensively for health publications and I am keenly aware of trends and new developments.
I embrace an active lifestyle combining diet, exercise and healthy choices. By working to inform readers of the options available to them, I hope to improve your health and quality of life.
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