Lately I’ve seen an increase of clients coming into the clinic with stuck big toes and “sleepy feet.” Using this Toe Sitting/Walking progression following manual work has been really helpful for my clients to regain foot function. Prior to using Toe Walking I often use Functional Range Release I learned from @DrAndreoSpina. Remember that often you must also address ankle dorsiflexion & hip stability in the process of fixing the foot.

1). Toe Sitting: Simply having the client tuck their toes under them and sit for a few minutes everyday can do wonders for opening up the 1st MTP. Initially, many clients will not be able to sit all the way back like in the video. Have them start by sitting in tall kneeling & progressively increase the load by sitting back on a bolster placed between their lower leg and butt. Once they are comfortable sitting all the way back you can cue them to contract and relax their toes as well as lightly rock forward and backward.

2). Toe Standing Holds: To hit the save button the new toe extension range you need to immediately start putting it to use. Have the client stand with the feet together and press up as high as possible.  I typically program 10, 5 second holds to start. If the client struggles to balance you can have them to brace against the wall for some support. Once they master 10 x 5 seconds you can increase the length of the holds.

3). Toe Walking: Following success with Toe Holds you can beigin incorporating Toe Walking. Have the client stand tall on their toes and walk lightly and slowly forward and backward. Progressively add steps as the become successful. You can also try lateral toe walking to provide them some movement variability. It is important you have them walk slowly. Clients who struggle will try to walk fast and cheat their way through the movement.

4). Beam Toe Walking: To provide an extra challenge have the client try toe walking on different surfaces. I like using these beams from @performbetter because they demand that the client slow down and focus on their foot placement. Varying surface, direction and pace is a great way to help develop dexterity in the foot and toes.