toe off


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toe off

; TO final period of foot contact during stance phase (of gait) preceded by forefoot loading and followed by swing phase; see Table 1
Table 1: Foot events occurring during normal bipedal gait
Stance phaseEvents/movements occurring
Leg 1
Heel strike (HS)Leg 1
STJ slightly supinated, so that:
• Posterior lateral area of the 'plantar heel pad' contacts the ground surface
• Forefoot is inverted relative to the ground surface
MTJ is also supinated, so that:
• Tibialis anterior tendon is contracted and prominent
• Limb decelerates
Hallux slightly dorsiflexed due to contraction of EHL
Leg 2
Knee of supporting leg is flexed
Heel off on supporting leg
From heel strike (HS) to foot flat (FF)Leg 1
STJ begins to pronate due to:
• Internal rotations within the lower limb
• Friction between the ground surface and the heel
MTJ also begins to pronate as:
• Tibialis anterior relaxes
• Ground reaction forces act on the fifth and fourth metatarsals
The plantar heel pad becomes weight-bearing
The lateral area, then the whole forefoot, loads rapidly
The hallux ceases to dorsiflex as soon as forefoot loading occurs
Once forefoot loading in leg 1 is completed (and leg 2 has undergone toe off) the STJ should pronate no further
Leg 2
Foot moving through propulsion phase, so that leg 1 loads fully as leg 2 undergoes toe off
From foot flat (FF) to midstance (MS)Leg 1
The leg and pelvis undergo external rotation
• STJ supinates
The knee is extended
• A bisecting line through the knee exits through the middle of the second metatarsal
• Leg 2 begins its swing phase
Midstance occurs when the leg is perpendicular to the ground
• The leg is directly over the foot
• STJ is neutral
• Tibialis anterior is relaxed
• Weight is evenly distributed across the heel pad
• MTJ is fully pronated
• Toes are flat to the ground surface, with no plantarflexion of the digits
• Leg 2 is in the middle of the swing phase and passes leg 1
Midstance (MS) to toe off (TO)Leg 1
As the body weight moves anteriorly over the foot, simultaneously:
• The knee flexes rapidly
• Gastrocnemius fires to bring about heel lift (just prior to heel contact of leg 2)
• Body weight transfers to the forefoot
The foot is supinating (due to the pull of gastrocnemius)
• There is no movement of the STJ, only movement at the MTJ
• MTJ locks to convert the foot to a rigid lever
Propulsion begins
• Body weight is distributed across the metatarsal heads
• First MTPJ is dorsiflexed but both first and fifth rays are parallel to the support surface
Propulsion continues
• The body weight continues to moves further forward
• First metatarsal plantarflexes and plantar aspect of first MTPJ becomes prominent
• Remainder of the foot supinates relative to the first ray and the height of the MLA increases
• Peroneus longus fires to stabilize the first ray (peroneus longus tendon becomes prominent)
• Body weight transfers from the lateral to the medial side of the foot
• Lateral aspect of the forefoot lifts (assists transference of body weight to leg 2)
• STJ supination reduces as foot begins to unload
Swing phaseEvents/movements occurring
Leg 1
Early swingPlantar aspect of first MTPJ still prominent
Toes dorsiflexed at MTPJs to allow ground clearance during swing
MidswingPlantar aspect of first MTPJ no longer prominent
Late swingSTJ and MTJ supinated due to contraction of tibialis anterior, EHL and EDL muscles

STJ, subtalar joint; MTJ, metatarsal joint; EHL, extensor hallucis longus; MTPJ, metatarsophalangeal joint; MLA, medial longitudinal arch; EDL, extensor digitorum longus.

References in periodicals archive ?
In the barefoot condition, the midfoot was plantar flexed at toe strike, then dorsiflexed, reaching maximum dorsiflexion at 58% of stance, and at toe off it was plantar flexed.
Our findings showed that there were significant differences between MS and healthy adults in the relative phase coordination between knee and ankle joints at heel contact and mid stance stages, but not at toe off and mid swing stages of the gait cycle.
This occurred at toe strike in the defensive scrum and toe off in the attacking scrum.
When he did it cut the carpet and the toe off my shoe.
The sword dance is tricky and tiring -one wrong move and I could have sliced my toe off.
Are you in the YES camp of souls who would sooner chew a toe off than be disconnected from the ether?
Everton hadn't just shot themselves in the foot, they'd blown every toe off.
com] Derby but for the injury which eventually led to him having the toe off.
When you run, focus on carrying yourself upright over your feet as you move to toe off.
A FORMER soldier who waited four years for an operation grew so desperate he chopped his own toe off with a chisel.
The dog has had a toe off, but you just wouldn't know it the way he runs.
AN ex-soldier who waited four years for an operation grew so desperate he chopped his own toe off with a chisel.