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I understand that it is all about reducing the force needed to dorsi-flex the hallux, and to establish it (windlass) as early as possible in range of hallux dorsi-flexion.


This has provided a useful tool to predict the efficacy of an orthotic device on foot function.

But should we be going all out to get the force as low as possible? Does the same go for timing (as early as possible)?


Something tells me deep in my gut that this utopia may lead to dorsal 1st MPJ arthridities/exostosis.

I realise that the literature detects a more central IOR in relation to the MPJ axis, with a plantar-flexed first ray. But, common-sense tells me that a hallux that can dorsi-flex with minimal force, with GRF in the magnitude of body weight and beyond, will force the 1st MPJ into osseous end-range and perhaps facilitate impingement etc.

Agree totally about the prospects of damage....

I think we are at the stage were we can definitivly say that reducing the force needed to establish the windlass mechanism with foot orthoses when that force is high does lead to better clinical outcomes. I just posted in the thread on Windlass enhancing running shoes that these shoes do appear to make the windlass function more efficiently when that force is high.

What we do not know, is the effect of reducing the force to establish the windlass mechanism in those who already have a low force. Especially the consequences to these people ... eg what is the effect of using these windlass enhancing running shoes in those who do not need the windlass enhanced - it may well be that there are no negative consequences and also no gains ...or there may be --- its still early days.

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Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia
http://www.latrobe.edu.au/podiatry
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God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University
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