Why toes are a key marker of longevity and mobility
Foot and toe strength declines with age, increasing the risk of falls and affecting confidence, balance and mobility, says foot and gait specialist Courtney Conley
Sunday Morning
25 August 2026
6 min read
Sunday Morning
25 August 2026
6 min read
Photo credit:Unsplash / Kateryna Hliznitsova
It’s no wonder world-renowned American foot and gait specialist Courtney Conley is raving about walking in her new book. She credits it with saving her life
“I struggled with some personal demons as I was growing up, and I ended up in a city in Chicago, and things were not going well,” Conley tells Sunday Morning
. “I decided to come to Colorado… I just said, ‘I’m going to walk up this mountain, and I’m going to keep going until I feel better’, and it really saved my life.”
Walking should be viewed as “a physiological necessity, like breathing and sleeping”, Conley says in Walk: Your Life Depends On It
, co-written with American physiotherapist Milica McDowell. But what if your feet are in pain?
Walk: Your Life Depends On It
Sunday Morning
“As we age, we know sarcopenia is a thing. We lose muscle mass. Well, that also occurs at your feet. People don’t think about that.”
Even for those who experience bunions (a painful bony lump at the base of the big toe), Conley encourages patients to develop an orthotic “exit strategy” through micro-dosing walks and exercises that strengthen the foot’s intrinsic muscles
While orthotics can be helpful, they can also weaken the foot if used long-term because the feet aren’t bearing the load, Conley says
“Or else you’re just dealing with pain that will show its face in the heel or the toe or the knee or the hip. It really starts to go up the chain as well.”
Finding appropriate footwear is equally important because many traditional shoes do not “respect the anatomy of your foot”, Conley says
Toe strength (“one of the biggest predictors of falls as we age”) and splay are also key factors in our ability to walk, she says. Toe strength is lost quicker than grip strength as we age, she says
“If you were to stand up and kind of lean forward, what stops you from leaning forward is pressure in the ground with your feet and in particular with your toes.”
Toe dexterity can be checked by seeing if you can you can raise and lower your big toe independently of the others, while splay can be tested by lifting your feet and spreading your toes to “see daylight” between them, she says
“The reason we want toe splay and why this is so important is when you’re walking and you go to push off, so this would be when your leg is behind you and your heel is coming up and you’re pushing through the ball of your foot, there is a lot of load going through that forefoot
“It needs to be wide, it needs to be stable, and it needs to be strong. Not only so that you don’t end up getting things like bunions and neuromas and problems in the foot, but it also helps align what’s happening at your knee and at your hip and at your low back.”
Improving ankle mobility may help those who experience pain when walking down the stairs or have difficulty with getting their knee to go over the foot, she says
“The other thing is your quadriceps strength – they’re the best shock absorption for the knee. Because typically people that walk downstairs and they’re in pain will be like, my knee hurts.”
Conley argues better awareness of your feet means better sensory input to the brain and therefore impacts on motor skills
“So being able to do these things, it’s kind of like a window into the brain.”
However, not all pain can be resolved through exercise and muscle strengthening. By the time some patients see her, more drastic measures are required
“Now, a lot of the patients, unfortunately, that by the time they get into my office, that bunion will be rigid, it will be tucked underneath their second toe, and that’s a very different conversation
“When the bunion is not flexible, when the foot becomes stiff, now we have the conversation of, ‘okay, do we need to put pins in this foot? Do we need to fuse the big toe?’ And when you start having those conversations, you really need to be cognisant of what is going to happen to the rest of your body.”
*Courtney Conley is a doctor of chiropractic medicine who specialises in foot and gait issues. She is the founder of Gait Happens, a global digital platform for foot health education
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25 August 2026
