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Dorsiflexion at the first metatarsophalangeal joint the plantar aponeurosis (a fibrous tissue band origi-
during the propulsive period of the gait cycle is im- nating at the calcaneus and inserting into the proxi-
portant for efficient foot function.1-5 During the pro- mal phalanges of the foot) as it was pulled distally
pulsive period of the gait cycle, the first metatarso- through its attachment to the proximal phalanx of
phalangeal joint dorsiflexes 45° to 65° as the body the hallux. This tension caused an increase in the me-
pivots over the hallux, which is fixed on the ground.6-8 dial longitudinal arch height through first-ray plan-
This dorsiflexion is responsible for establishing the tarflexion and midtarsal and subtalar joint supination,
windlass mechanism, originally described by Hicks,5 resulting in the foot being a stable structure during
who demonstrated that dorsiflexion of the first propulsion. 9 Inadequate dorsiflexion at the first
metatarsophalangeal joint generated tension within metatarsophalangeal joint during propulsion, there-
*School of Human Biosciences, La Trobe University, Vic- fore, has been cited as a major cause of abnormal
toria, Australia. foot function.1-5, 10
†Gippsland Foot Clinic, Traralgon, Victoria, Australia.
Corresponding author: Shannon E. Munteanu, PhD,
Functional and structural deformities, including
School of Human Biosciences, La Trobe University, 3086 functional hallux limitus,2-4, 11 hallux rigidus,12-18 and
Victoria, Australia. hallux abducto valgus,12, 13, 19-21 have been reported to
Participants