The Importance of Toe Strength in Fall Prevention in the Elderly

Commentary by a toe doctor

Keiro Yuasa

Physical Therapist, Doctor of Toes, Director of Toe Research Institute, President of the Japanese Society of Functional Foot and Toe Therapy, and developer of Halmek shoes. Former director, vice president, and medical director of General Hospital. His specialties are exercise physiology and anatomy. He is also a foot and shoe specialist and a leading expert in postural occlusion therapy. He has cured various orthopedic diseases (over 70,000 people) with toe therapy alone.


The Link Between Fall Prevention and Toes

Data show that each year, approximately 40% of seniors over age 70 fall at least once!1). Falls greatly increase the risk of sprains, separated flesh, and bruises, as well as fractures. When these injuries occur, weakness and frailty can develop, creating a vicious cycle. In addition to the risks associated with falls, the medical costs associated with fall-related procedures and treatments can be enormous. For example, in Japan alone,Medical and nursing care costs for the elderly after a fall reach approximately 730 billion yen per year.2)It is considered to be a

Surprisingly, the best predictor of falls in the elderly is toe strength. In a prospective study of 300 older adults, Mickle et al.3)Ha,Older adults who do not fall have 20% higher toe strength than older adults who do fall.They found that Interestingly, there was no difference in quadriceps or ankle strength between fallers and non-fallers, confirming that toe muscle weakness, not generalized muscle weakness, was the cause of falls. Unfortunately, toe muscle weakness is very common in the elderly. When compared to younger people,Toe muscle strength in the elderly decreased by more than 35%and greatly increases the risk of falls!4)The following is a list of the most common problems with the

To understand the relationship between toe strength and fall risk, first place your arms next to your body and keep your hips and shoulders in alignment. Next, bend forward while maintaining this posture. Notice how your toes, especially your thumbs, press against the floor, preventing you from tipping forward. The distance one can lean forward while maintaining balance is called the forward fall envelope, and those at higher risk of falling among the elderly have smaller forward fall envelopes. Strengthening the toes helps control the subtle forward tilt that occurs when grasping objects or moving forward (when falls are most likely to occur), thus reducing the risk of falls.

What is the Forward Fall Envelope?

A concept used in physics and engineering that refers to a shape or curve that represents the stability of a particular system or structure as it tumbles (falls) forward.

The latest training to reduce the risk of falls

Simple exercises to reduce a patient's risk of falling include hironoba exercises, yoshiro socks, and the forward tilt method. In particularYOSHIRO SOCKSand ... andgymnastics (esp. at Hironoba Gymnastics)The fall-preventive effects of the "M" series have been attracting more attention in recent years.

gymnastics (esp. at Hironoba Gymnastics)

gymnastics (esp. at Hironoba Gymnastics)is said to be effective in reducing the risk of falls and injuries, as well as enhancing the body's overall sense of balance and muscle strength by standing with the toes firmly spread apart. By spreading the toes firmly, the sole of the foot becomes more activated and the ground contact area is expanded. This helps stabilize the body's center of gravity and improves the sense of balance. In addition, by spreading the toes, the range of motion of the toes' muscles and joints is widened, which increases stability during walking and standing.

The proper way to do Hironoba Exercises

Also,gymnastics (esp. at Hironoba Gymnastics)The toes and foot muscles are strengthened by the "toes and feet" system, which increases the ability to firmly grasp the ground in the event of a fall. By increasing the number of movements that use the muscles of the feet, such as standing on tiptoes and jumping, the feet naturally reach the ground more firmly in situations where there is a sudden loss of balance, thereby preventing falls.

Further,gymnastics (esp. at Hironoba Gymnastics)also improves blood circulation in the toes and feet. Strengthening the muscles in the soles of the feet promotes blood circulation, which also improves the sensation and smoothness of movement of the feet. This in turn sharpens the senses for ground conditions and inclines, further reducing the risk of falls.

gymnastics (esp. at Hironoba Gymnastics)can be easily incorporated into daily life, making it easy for anyone to start. Start with something as trivial as stretching in the morning and evening or being conscious of spreading your toes when walking. Do it while being aware of the power of your toes and feet.gymnastics (esp. at Hironoba Gymnastics)is an effective mechanic for fall prevention. We encourage you to incorporate them into your daily life to keep you safe and comfortable.


YOSHIRO SOCKSHa,Correct position of toesThe sock was developed as a sock that can keep the toes in the right place. This sock maintains proper spacing between the toes. Due to this design,Correct position of toesThe foot is able to use the feet and foot muscles correctly by being housed in the

Correct position of toesThe toes are kept within the foot, which allows the foot muscles to function properly and strengthens the support of the foot. In addition, proper spacing between the toes improves the sensation in the foot. This provides more accurate sensation of the sole when walking and reduces the risk of falling.

Further,YOSHIRO SOCKSare socks made with special (non-slip, moisture-absorbing and quick-drying) fibers that allow stable walking without slipping on the soles, thus reducing the risk of falls. In addition, the use of moisture-absorbing, quick-drying fibers quickly absorbs perspiration from the feet to keep them comfortable. Since socks play a major role in walking, it is important to choose appropriate socks to prevent falls.

YOSHIRO SOCKS designed to keep toes in proper position
To reduce stress on the Achilles tendon, it is important to have open toes.

Effect of YOSHIRO SOCKS on falls


The forward reach distance at the start is350mm
The forward reach distance after SOCKS is installed is405mm

After wearing SOCKS, the average forward reach distance improved by 14% compared to the start of the study. The action of fall prevention was confirmed.

*Functional Reach Test (FRT) evaluates fall risk and balance ability by measuring the maximum distance that can be reached forward in a standing position.
*Difference between average values before and after SOCKS installation
*Graphs show average values in clinical trials.
*Results may vary from person to person and are not guaranteed to be 100%.

What is FRT?

The functional reach test is a test that assesses an individual's ability to reach forward and maintain physical balance. This test is used to measure balance ability, which is important in daily life and in sports. Results are expressed as a numerical value that indicates an individual's ability to balance, which can be useful in developing intervention programs to prevent falls.

The result of a 14% improvement just by wearing YOSHIRO SOCKS is a relatively large effect by general standardsIn general, the degree of effectiveness varies from situation to situation, but a 14% improvement is quite noticeable. In general, the degree of effectiveness depends on the situation, but a 14% improvement is quite noticeable. Therefore, YOSHIRO SOCKS is a useful item in the Functional Reach Test results.

forward slant method

Another next step is to perform the forward incline method. In this exercise, begin by standing in front of a wall with your hips and torso straight.Patient slowly leans forward while pressing toes into the ground. The downward force exerted by the toes limits the forward movement of the torso, thereby increasing the forward fall range.Hold this position for 5 seconds, then press down hard with your toes to return to the original vertical position. Repeat this 20 times a day.The following is a list of the most common problems with the

The most important factor in falls in the elderly is the strength of the flexor digitorum longus, and patients should focus on increasing pressure under the big toe, especially when leaning forward or pushing back3)The "Mickle et al. Indeed, Mickle et al.(6)has shown that for every 11 TP3T increase in weight that occurs under the big toe, there is a 71 TP3T decrease in fall risk. For example,For a woman weighing 45 kg, just 1 kg of force under the big toe reduces the risk of falling by 141 TP3TThe following is a list of the most common problems with the

The big toe can exert a downward force equivalent to 52% of body weight7)and that strengthening the toe muscles can reduce the risk of falls.After a few months of simple toe exercises, the force applied under the big toe increases by 30%It is often seen that Once these exercises are mastered, one can move on to more aggressive toe exercises. Toe muscle strength instruments can be used to accurately measure toe muscle strength before and after exercise intervention. The initial muscle strength score indicates to the physician and patient the importance of exercise, while the later scores serve as a guideline for evaluating the effectiveness of the exercise protocol.

Because of the demonstrated link between weak toe muscles and risk of falling in older adults, it is important to incorporate toe stretching and strengthening into daily routines.gymnastics (esp. at Hironoba Gymnastics)and ... andYOSHIRO SOCKSand other toe exercises can strengthen the toe muscles and reduce the risk of falls in older adults.

Keiro Yuasa
Doctor of Toe (Physical Therapist)
Leading expert in toe research. Physical therapist. Director of the Toe Research Institute. President of the Japanese Society of Functional Toe Therapy. Developer of Hironoba Gymnastics, YOSHIRO SOCKS, YOSHIRO INSOLE, and Halmek shoes. Conducted research at the University of Tokyo and International University of Health and Welfare. Former director, vice president, medical director, and head of the day-care rehabilitation center at General Hospital. Author of numerous books. He has appeared on "Gaia no Yoake (Dawn of Gaia)," "NHK Gatten," "NHK BS New Common Sense of Beauty and Youth," "NHK Sakidori," and many other TV programs, and has written many books, including "Grab Your Toes in Just 5 Minutes and Your Hips and Back Will Never Swing Again! (PHP Publishing Co., Ltd.) and many others.

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