Saturday, May 05, 2012

Passive Orthodigital Therapy

YogaToes® is a patented ergonomically designed toe orthoses which consist of a two part assembly containing a refrigerant gel or liquid. The top (or dorsum component) links to a twin plantar (bottom) segment through the toe webbing and acts like toe stocks separating each toe. Using the principle of stretch the digits are fully extended away from the ball of the foot and down from the top of the foot. Parting the toes is generally thought to be good for foot health and passive stretching of the digits helps comfort tired feet. Other claims include improvement in peripheral circulation, increased muscle tone and better posture. Not to be worn weightbearing or in shoes manufacturers recommend wearing YogaToes® when sitting reading or watching television. They can be used to relax in the pool or worn overnight in bed. Cool YogaToes® which can be chilled in the freezer to give a cooling action on a hot summer day or after a long day in shoes and YogaToes® Deluxe Massagers Deluxe Massagers have a special battery operated vibrator addition to give gentle massage to the toes. YogaToes® are available in a variety of sizes. Independent medical evidence to support the use of this type of toe seperator is scant and buyers should always beware. Presented anecdotal evidence however seems to suggest the use of passive orthodigita can be beneficial to some although not everyone. Success with this type of passive traction is most probably based on Wolffs’ and Davis’ Laws where soft tissue and bone can accommodate change under traction. How much this can be achieved is almost certainly dependent upon the quality and range of motion available at each joint.

The trend to separate toes in footwear has been seen with the rise in popularity of Vibram Five Fingers and yoga toes training sandals. Five finger socks are also popluar footgear for yoga and barefoot running.

A more dynamic approach are silicone toe orthoses which can be worn during weightbearing and prescribed and made by a podiatrist in minutes. Using malleable silicone elastomers the device is fitted beneath the three middle toes and set within a few minutes. Special manipulation of the foot locks the bones to simulate the foot in midstance while the device is setting.

The integrity of the material is such that it resists compression and exhibits good recall (elasticity) whilst feeling comfortable next to the skin. With each step the device in situ has the effect of bringing ground reaction to meet the plantar surface of partially dislocated (subluxated) toes throughout late propulsion to toe off. The resultant windlass action offers an anti- pronatory turning effect (or supinating moment) on the rearfoot. The dorsiflexed toes tightened the plantar fascia and raise the longitudinal arch of the foot. Determined by Newton's Third Law of Motion the action reaction effect of standing on the material caught beneath the toes has the potential to increase the muscle tone in both extrinsic and intrinsic musculature. The three middle metatarsals offers a stable platform for propulsion and the dynamic toe orthosis has optimal effect when worn under the three middle toes using the natural gaps between toe 1/2 and 4/5 as attachments. Devices are worn in series and dynamic changes can be measured.

Researchers at Victoria University have been testing the theory muscular strength of the toes is a significant predictor of future falls in the elderly. According to Dr Karen Mickle, “people with weak tone in their toes and toe deformities are twice as likely to fall over.” Researchers developed an exercise program using resistance bands to improve foot strength and balance. Participants who attended classes three days a week for 12 weeks increased their toe strength by an average of 36%. This is only a pilot study and there is a lot more work to do., but the provisional results are encouraging.

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