I think most of us have heard of the ‘too many toes sign’. This is when there are more than a few of the toes are visible on the lateral side due to an abduction of the forefoot when standing or walking.

This image from a screen grab of video that I did of a case I talk about during the Clinical Biomechanics Boot Camp could just about be considered as the “too many toes” sign:

Below is a screen grab of the video of the other foot. I like to call that one the “all the toes” sign rather than just the “too many toes” sign as all of the toes are visible laterally.

The key point in talking about this case was that it was the right foot that was the painful one and the left one with that severe “overpronation” was not the problem one. This means that the “too many toes” sign is not something to be necessarily worried about. What you need to be worried about is the forces behind the foot posture and be worried about them if they are high.

The “too many toes” sign is not really good terminology and is just something that clinicians may say to patient as part of a conversation. It is not a diagnosis. It is probably better to use the components of the Foot Posture index to put a number on the amount of forefoot abduction rather than just say too many toes.