Dooley Noted: 12/15/15
The Abductor Hallucis is the primary mover of the great toe medially (relative to the body) away from the second toe.
This concentric action, known as great toe abduction, is crucial for spreading the surface area of the forefoot during foot pronation.
The eccentric loading of this muscle is important during propulsion, helping the great toe load and explode via the powerful movement of an elongated Flexor Hallucis Longus.
Thus, Abductor Hallucis finishes pronation during tvhe suspension phase of gait, while it helps initiate propulsion.
If one never finishes pronation, they will have incomplete propulsion.
But this foot may get clever in some individuals.
The Adductor Hallucis starts to drag the great toe outward, creating a situation called hallux valgus. This reciprocally inhibits Abductor Hallucis, leaving the muscle dormant.
With the Adductor Hallucis going unopposed, the weight starts moving to the outside of the foot, creating a false supination. As toe flexors and supinators get over-recruited, the great toe starts to turn ventrally (towards the floor), making a new position for the already down-regulated Abductor Hallucis.
Abductor Hallucis now becomes in a perfect position to flex the first metatarsal even more towards the ground. The excessive force creates a bunion.
A bunion is a supination strategy. But it doesn’t mean you supinate well.
You’ll never be great at supinating if you can’t first load the foot into pronation.
And since Abductor Hallucis finishes pronation, a bunion foot can neither pronate nor supinate well.
The foot gets caught in flux.
But it can change.
And even if you’ve already had bunion surgery, you absolutely, positively need to change this. Remember: your system is dynamic, and surgery is static.
In bunionectomy, the Adductor Hallucis is often cut to prevent great toe migration outwards. That doesn’t mean the great toe understands suddenly how to abduct again.
The great toe must learn to decompress out of flexion and return to a state of abduction.
On the drdooleynoted YouTube, you can learn ways to retrain great toe abduction passively with great toe decompression. You can also learn to coach pronation in half-kneeling prior to learning it standing.
If pronation is the key to excellent supination, you may need to to learn both.
Help is here.
Get assessed. Get corrected.
NKT and AiM practitioners are excellent choices to help you.
The better you can abduct the great toe, the better cueing the knee, hip, foot, and spine get to distribute force from the ground up – no matter the task.
As always, it’s your call.
– Dr. Kathy Dooley
Some additional links to drdooleynoted videos:
Half-kneeling pronation:
Great toe decompression:
Triplanar stability drill for front foot pronation: