The 1st Toe Extension Test measures how far the big toe can extend. It is useful for understanding first toe mobility in walking, running, lunging, calf raises and push-off tasks.
A client may report stiffness under the big toe, discomfort during lunges, or reduced push-off when walking or running. First toe extension can influence how the foot moves during late stance and toe-off.
This test provides a clear way to record big toe extension range of motion and track change over time. It should not be interpreted as a complete measure of foot function on its own. Interpretation is stronger when combined with symptoms, footwear context, ankle range of motion, calf strength, gait, running and forefoot-loading tasks.
Test name: 1st Toe Extension Test
Also known as: First MTP Extension Test, Big Toe Extension Test, Hallux Extension Test
Purpose: Assess first toe extension range of motion
What it assesses: Extension range at the big toe, commonly at the first metatarsophalangeal joint
Equipment: Measurz inclinometer or goniometer
Key finding: First toe extension angle in degrees
Best used with: Ankle dorsiflexion, plantarflexion, calf raise testing, gait and running assessment
Key limitation: Big toe ROM alone does not explain foot symptoms or push-off performance.
The 1st Toe Extension Test measures extension of the big toe, most commonly at the first metatarsophalangeal joint. It records how far the big toe can move upward relative to the foot.
The first metatarsophalangeal joint is important during walking because the big toe needs to extend during late stance and toe-off. Restricted first MTP extension may affect how the foot rolls forward, but static ROM does not always directly match dynamic walking or running function. A 2020 study on first MTP joint osteoarthritis noted that the relationship between clinical maximum dorsiflexion and dynamic joint function during walking is inconsistent, so results should be interpreted with movement findings rather than in isolation.
First toe extension is relevant for:
Walking.
Running.
Sprinting.
Lunging.
Calf raises.
Forefoot loading.
Late stance and push-off mechanics.
Foot and ankle mobility tracking.
The test is used to establish baseline mobility, compare sides and monitor changes across sessions.
The test measures first toe extension ROM in degrees.
It does not directly measure:
Calf strength.
Foot strength.
Gait quality.
Pain source.
Push-off power.
Running readiness.
Forefoot loading tolerance.
Overall foot function.
A reduced score may add context to walking, running, lunging or calf raise findings, but it does not explain the cause by itself.
First toe extension can be assessed actively or passively.
Active first toe extension means the client lifts the big toe upward using their own effort.
Passive first toe extension means the professional moves the toe into extension while the client remains relaxed.
Passive testing is common when the goal is to assess available joint motion. Active testing provides more information about the client’s controlled movement. Record the method used and repeat the same method when retesting.
This test may be useful for:
Runners.
Walkers.
Dancers.
Field sport athletes.
Gym clients.
Foot and ankle mobility clients.
Clients with forefoot-loading concerns.
Clients where push-off, lunging, calf raises or gait need more context.
Use caution when the client has acute toe pain, recent forefoot injury, high irritability, swelling, severe discomfort or symptoms that meaningfully change movement quality.
Measurz inclinometer or goniometer.
Treatment table or mat.
Measurz app.
Notes for pain, symptoms, active/passive method and side comparison.
Ask the client to remove shoes and socks. Position the foot so the big toe can move freely.
Stabilise the first metatarsal to reduce unwanted forefoot movement. This helps ensure the measurement captures first toe extension rather than whole-forefoot lifting.
Use the Measurz inclinometer or a goniometer. Align the device consistently with the toe and foot landmarks according to the chosen protocol.
For active testing, ask the client to lift the big toe upward as far as comfortable.
For passive testing, gently move the big toe into extension while stabilising the first metatarsal.
Use consistent wording, such as:
“Move your big toe upward as far as you comfortably can without lifting the whole forefoot.”
Pause at end range and record the angle in degrees.
Repeat on the opposite foot when side comparison is useful.
Ask where the client feels the movement. Record pain, stiffness, stretch, pressure, pinching or symptom location.
Stop if symptoms meaningfully change the movement or the client cannot maintain the test position.
Record first toe extension ROM in degrees.
Compare:
Left versus right side.
Active versus passive ROM, if both are tested.
Baseline versus retest.
ROM with symptoms.
ROM with gait, running, calf raise and lunge findings.
ROM with footwear demands and sport/activity context.
A lower ROM result may add context to walking, running, lunging or calf raise findings, but it does not explain the cause by itself. Interpretation is stronger when combined with pain score, symptom location, ankle dorsiflexion, calf strength, gait findings and footwear context.
Evidence level: Level 2 — closest available published reference values.
Exact norms for this specific Measurz inclinometer setup are limited, but published first MTP extension values provide useful context.
A commonly reported reference for normal first MTP extension is approximately 70°, with many clinical sources describing expected dorsiflexion/extension around 70–90°. Functional gait is often reported to require approximately 35–40° minimum and commonly around 45–60° of first MTP extension during toe-off, although values vary by walking speed, footwear, foot posture and measurement method.
For practical Measurz interpretation:
Around 70° or more may be a useful general reference for available first toe extension.
Around 35–40° may represent a commonly cited minimum for functional walking demands.
Around 45–60° may be a useful gait-related reference range for toe-off.
Use these values as contextual benchmarks, not strict pass/fail cut-offs. Static first toe extension does not always match dynamic walking or running function, so interpret results with symptoms, side-to-side comparison, active/passive method, footwear, calf strength, ankle dorsiflexion and gait or running findings.
Reliability depends on stabilising the first metatarsal, using consistent device placement, measuring the same joint movement and recording the active/passive method.
A study comparing a smartphone goniometer app with a traditional goniometer for first MTP joint dorsiflexion reported that goniometric measurement is commonly used for 1st MTP joint assessment and examined intra-rater reliability, inter-rater reliability and concurrent validity for passive motion measurement. This supports the importance of using a consistent method and device when tracking change.
Earlier work also examined reliability and validity of different static first MTP extension measurement techniques and highlighted that measurement approach can influence interpretation.
Small ROM changes should be treated cautiously unless the same setup, stabilisation, device, tester instructions and active/passive method are repeated.
Common errors include:
Failing to stabilise the first metatarsal.
Allowing the whole forefoot to lift.
Measuring soft tissue movement rather than toe extension.
Ignoring pain or pressure under the toe.
Comparing active and passive results directly.
Changing device placement between sessions.
Assuming big toe ROM alone explains gait or push-off performance.
Limitations include:
Static ROM may not match dynamic gait function.
Footwear and loading demands can change functional toe extension.
Pain may limit ROM independently of available joint range.
Device placement affects measurement.
Active ROM may differ from passive ROM.
Big toe extension does not measure calf strength or push-off power.
Use this test to:
Track big toe mobility.
Compare left and right sides.
Inform foot and ankle exercise programming.
Add context to gait, running and push-off findings.
Monitor changes during mobility or loading programmes.
Support interpretation of calf raise, lunge and forefoot-loading tasks.
For example, a client with reduced first toe extension, forefoot discomfort and early heel lift during gait may need different interpretation from a client with similar ROM but no symptoms and normal running tolerance.
Record:
Test name: 1st Toe Extension Test.
Side tested: left or right.
Score: first toe extension ROM in degrees.
Method: active or passive.
Position: seated, lying or the specific position used.
Device: Measurz inclinometer or goniometer.
Landmarks/device placement: record the placement used.
Stabilisation: first metatarsal stabilised or not.
Pain score: 0–10.
Symptom location: under big toe, top of first MTP joint, plantar fascia, forefoot or other.
Symptom quality: stiffness, stretch, pressure, pinch, pain or block.
Comparison side: opposite foot.
Related findings: ankle dorsiflexion, plantarflexion, calf raise testing, gait, running, lunge or footwear findings.
Progress comments: whether ROM improved, symptoms changed or side-to-side difference reduced.
Retest date: for monitoring change.
This improves repeatability, client education and long-term progress tracking.
Ankle Dorsiflexion Test
Ankle Plantarflexion Test
Weight-Bearing Lunge Test
Single-Leg Calf Raise Test
Calf Raise Repetition Maximum Test
Gait Assessment
Running Assessment
Lunge Assessment
It measures how far the big toe moves into extension, usually at the first metatarsophalangeal joint.
First toe extension can add context to push-off during walking, running, lunging and calf raise tasks. It is especially relevant during late stance and toe-off.
A commonly used reference is approximately 70° of available first MTP extension, while walking may require approximately 35–40° minimum and often around 45–60° during toe-off. These values should be interpreted with symptoms, footwear, side comparison and movement findings.
Either can be used. Active testing measures controlled movement. Passive testing measures available assisted range. Record the method and repeat it consistently.
No. It depends on symptoms, side-to-side comparison, footwear, sport or activity demands, and related movement findings.
Use the same position, device placement, side, active/passive method and Measurz recording fields each session.
The 1st Toe Extension Test measures big toe extension ROM.
Stabilise the first metatarsal for consistency.
Record pain and active/passive method.
Around 70° is a useful general reference for available first MTP extension.
Around 35–40° minimum and 45–60° during toe-off are useful functional gait-related references.
Interpret results with gait, running, calf raise, footwear and ankle findings.
Track progress in Measurz across sessions.
Hales, G., Keating, R., Bear, N., Warren, K., & Otter, S. (2015). Reliability of a smartphone goniometer app compared with traditional goniometer for measuring passive motion at the first metatarsophalangeal joint. Journal of Foot and Ankle Research, 8(Suppl 2), P12. https://doi.org/10.1186/1757-1146-8-S2-P12
Kiatkulanusorn, S., Luangpon, N., Srijunto, W., Watechagit, S., Pitchayadejanant, K., Kuharat, S., Anwar Bég, O., & Paepetch Suato, B. (2023). Analysis of the concurrent validity and reliability of five common clinical goniometric devices. Scientific Reports, 13, 20915. https://doi.org/10.1038/s41598-023-48344-6
Norkin, C. C., & White, D. J. (2016). Measurement of joint motion: A guide to goniometry (5th ed.). F. A. Davis.
Zammit, G. V., Menz, H. B., Munteanu, S. E., & Landorf, K. B. (2020). First metatarsophalangeal joint range of motion is associated with lower limb kinematics in people with first metatarsophalangeal joint osteoarthritis. Journal of Foot and Ankle Research, 13, 33. https://doi.org/10.1186/s13047-020-00404-0
