Abstract.[Purpose] The towel gathering exercise is commonly chosen in the treatment of painful accessory navicular. However, the effect has not been well documented in clinical settings. So we compared the reduction in pain effect of towel gathering exercise with those of three toe flexor exercises we developed. [Subjects and Methods] Fifteen accessory navicular cases (4 males, 11 females) were chosen as subjects. Their mean age was 20.3±10.7 years old. The three exercises were almost maximal isometric contraction of first toe flexor, 2nd-to-5th toe flexors and 3rd-to-5th toe flexors. All subjects randomly performed the three toe exercises and the towel gathering exercise. Before and after each exercise we assessed the pain by provocative tests such as stepping and others using a visual analog scale (100 mm).[Results] The exercises of 2nd-to-5th toe flexors and 3rd-to-5th toe flexors showed overtly significant improvement of pain. On the other hand, the effects of both the towel gathering and first toe exercises were less significant. Especially, the towel gathering exercise showed the poorest effect of pain relief.

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Abstract. [Purpose] This study analyzed toe exercises using surface electromyograms. [Subject and Methods ] The subjects were 26 feet of 16 participants, whose mean age was 25.7 ± 7.2 years old. The participants did three toe exercises, which were isometric contractions (about 5 sec) of the first toe flexor, 2nd-to-5th toe flexors and 3rd-to5th toe flexors. An electrode was attached to four muscles: the longus peroneal, supinator muscles, and the medial and lateral gastrocnemius muscles. [Results] In the first toe flexor exercise, the peroneus longus muscle activity increased significantiy more than the other muscles. In 2nd-to-5th toe flexor and 3rd-to-5th toe flexor exercise, the supinator muscle activity increased significantly compared to the peroneus longus muscle, and the peroneus longus muscle activity decreased significantly compared to the medial head of the gastrocnemius muscle.[Conclusion] The first toe flexor exercise affected the long peroneal muscle as well as the flexor hallucis longus. On the other hand, the 2nd-to-5th toe flexor and 3rd-to-5th toe flexor produced the opposite result to that of the first toe exercise.

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[Purpose] The toes play an important role, yet the role of toe flexor strength is poorly understood. We have performed clinical and electromyogram (EMG) studies of the toe exercises we developed. However, the relationship between our toe exercises and the medial longitudinal arch (MLA) has remained unclear. The purpose of this study was to examine the relationship between the toe exercises and MLA. [Subject and Methods] The subjects were 20 feet of 20 participants (10 males, 10 females), whose mean age was 22.5 3.6 years old. The participants performed three toe exercises and the towel gathering exercise. The three toe exercises were isotonic contractions (10 times) of the great toe flexor, 2nd-to-5th toe flexors and 3rd-to-5th toe flexors. All subjects randomly performed the three toe exercises and the towel gathering exercise. Before and after each exercise, we assessed MLA using the Navicular Drop test (ND).[Results] ND before the training was 4.34 mm. ND after towel gathering was 4.94 mm, without a significant difference from before exercise. After the great toe exercise, ND was 5.25 mm, a significant drop compared with before exercise. After the 2nd-to-5th toe flexors and 3rd-to-5th toe flexors exercises, ND was 3.07 mm, and 3.32 mm respectively, with no significant drop in comparison with before exercise.[Conclusion] The great toe flexor exercise significantly decreased MLA. The relationship between the towel gathering exercise and MLA was poor. However, this exercise is similar to the great toe flexor exercise. On the other hand, the exercises of 2nd-to-5th toe flexors and 3rd-to-5th toe flexors increased MLA.