Wednesday, April 2, 2014

Gear Review: Correct Toes

First of all, allow me to apologize for my sparse updates lately. Midterms hit, and then Part I of Boards, and next week is finals. Between this trimester's course load and Boards, I can see why they've dubbed fifth tri "hell tri." I also wanted to get some time with this particular product before I got a review up, since it's not one of those products where I'd expect to put them on, and within a week or so have a good opinion of them. Nope, this is something that I wanted to have a little bit more time with, and also get through the majority of this trimester's Postural Assessment course before I went and reviewed. However, I have a short breather before finals, and I've spent a couple months with playing with these now, so here we's the Correct Toes review!

Correct Toes are a toe-spacer product developed by podiatrist and runner Dr. Ray McClanahan. Dr. McClanahan's goal was to create a product that allowed the foot to function optimally by returning the foot to its natural shape (that is, to reverse any deformity caused by ill-fitting footwear). Correct Toes are built to assist in the treatment of many foot conditions, including (but not limited to) bunions, plantar fasciosis, hallux rigidus and limitus, and neuromas. Additionally, aligning the feet will have an effect on the rest of the kinetic chain, and therefore help with the treatment of runner's knee and osteoarthritis (and I'd argue that better foot alignment would also assist with maladies such as shin splints, low back and SI joint pain, certain hip problems, etc, though they're either not listed on the website or I'm missing them). They're also designed to improve proprioception (where your brain perceives your body to be in space) and improve balance, both of which should have a positive impact on performance.

Now, before we go on, let me get it out there that I'm not anti-orthotics. Studies show that they do work in that they reduce pain, move around muscle loads to stress appropriate muscles (Surprise, your muscles don't go to sleep with orthotics!), and actually strengthen your feet (I can't remember who authored that last study, so if you have questions, go bother Craig Payne, since he cites it all the time). I'm also not anti-surgery. However, I also believe that there's no magic bullet treatment that works for everyone, and you have to take each individual's case into account. For many people, orthotics are not the answer, and it drives me crazy when they're prescribed willy-nilly without accounting for why there's dysfunction present...especially when you consider how expensive custom orthotics are. Additionally, I believe that there are very few cases where you should not attempt a conservative approach first, so I would certainly recommend trying something like Correct Toes or orthotics (combined with stretching and exercise as appropriate, as well as soft tissue work, mobilization, manipulation, etc as appropriate) before resorting to medication or surgery.

So the big question: do Correct Toes work? Well, after a lifetime of shoes of different shapes and 15 years of running, I'm not expecting a couple months of Correct Toes to have noticeable results on my feet. At least not yet. However, I will say that the premise makes sense, though they would most likely need to be paired with appropriate stretching of tight, facilitated (and usually weak) muscles, and strengthening of weak, inhibited muscles in order to see any measurable difference. This is something where you'd probably be best off talking to a specialist about (podiatrist, chiropractor, physical therapist, physiotherapist, etc), and part of why, as a chiropractic student, I contacted Dr. McClanahan about these in the first place: so I can recommend them as appropriate in my practice. That said, for $65, Correct Toes are a relatively inexpensive intervention that may aid you in getting the results you want.

I've found Correct Toes to be reasonably comfortable once you adapt to them. They're soft and malleable, and they don't interfere with walking at all. In fact, you may actually feel additional toe muscle engagement when wearing them while walking. Not so comfortable with shoes (more on that later), but as long as I'm just walking around barefoot or in socks, I can pretty much forget I have them on. My fifth toe occasionally slips out, but that's the only issue, and it doesn't happen with socks on. Additionally, Correct Toes are customizable to work with your feet, and you can cut them or add shims as appropriate.

So why pay $65 for Correct Toes over say, Yoga Toes, which can be found for just over half the price of Correct Toes, or nail polish toe spacers, which can be had for a couple of bucks? Really, this is where you're paying for quality. Correct Toes gets you medical-grade silicon, but more importantly, a design from an actual podiatrist who understands feet. They're not a weird bulky shape that are impossible to walk with, and the spacing between each toe was thought out by an educated healthcare professional. And, as mentioned before, unlike Yoga Toes or nail polish toe-spacers, Correct Toes can be modified to work for your individual feet.

Correct Toes are meant to be able to be worn throughout the day with shoes (following an adaptation period...please see the manual and don't attempt to wear Correct Toes all day as soon as you receive them). Dr. McClanahan provides a list of shoes that Correct Toes can be worn with. Something to keep in mind, because they do not fit comfortably in any of my shoes, not even the Brooks PureDrift with the insole removed and no socks, which probably has the widest toebox of any of my shoes (and taking out the insole and skipping socks adds even more volume).

Of course, we do have to be reasonable. If you've worn high heels with pointy toes for 30 years and have massive bunions, a couple months of Correct Toes isn't going to magically fix that. Additionally, if you have a weak windlass mechanism or your tibialis posterior has a short lever arm to work with (to translate that into non-medical speak, your pronation is due to certain anatomical structural characteristics), Correct Toes won't magically change that either.

One more warning: Correct Toes involves placing silicon between your toes. If you have diabetes or other neurologic or vascular problems, they are probably not for you. If you have any other questions about whether Correct Toes are appropriate for you, please consult with your healthcare provider before purchasing!

The premise behind Correct Toes makes sense, and I can see them being a valuable part of rehabilitation for injuries and pain where foot alignment is the primary cause of the disorder. This is not limited to foot problems, since the foot is a crucial part of a kinetic chain that involves everything from the rest of the lower extremity to the spine and the rest of the body, though not every lower extremity or back problem is stemming from a foot alignment issue (and often foot dysfunction is a secondary manifestation of a problem elsewhere). I am glad that, as a chiropractic student who favors conservative treatment over invasive procedures whenever possible (or at least initially, in that conservative measures should be attempted first before moving to invasive procedures), I am aware of Correct Toes, and can see myself recommending them to certain patients in my practice in the future, and I would certainly recommend them to those of you who may be suffering from foot alignment problems. However, I do caution you that patience is required, and that like any other treatment, they are not magic.

Correct Toes retail for $65 and can be purchased from Dr. Ray McClanahan at the Northwest Foot & Ankle website. The user manual, which includes instructions on how to use Correct Toes, as well as sizing information, is also available online.

Full disclosure: Correct Toes were provided free of charge in exchange for a review. All opinions expressed in this review are mine and based on my experience, and do not reflect the opinions of Correct Toes, Dr. Ray McClanahan, or Northwest Foot & Health.

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