Toe separators: the "miracle" that neither podiatrists nor physiotherapists recommend.

"The topic of toe separators is very strong every time you see them. I always wear them for training and around the house, they give me more stability and help my foot and toes return to their natural shape. They prevent bunions, claw toes, ingrown toenails..." This specific message is from Cristina Pedroche , but it's just one of many seen on social media about toe separators.

One of the websites selling this device mentions the following benefits : "They promote natural toe expansion, which can contribute to a feeling of greater mobility and stability during physical activity and in your daily life. They can also help improve the feeling of support and strengthen the intrinsic muscles of the foot, optimizing well-being in your self-care routines."

However, there are professionals who disagree with such uses. This is the case of Pedro Rubio Montoro , spokesperson for the General Council of Physiotherapists. He is well-versed in toe anatomy, having begun teaching foot physiotherapy at the university in 1998 and consulting in his own clinic . "There's a lot of talk about the excessive use and miracles of separators, but they're not terribly useful. They only provide a minimal amount of temporary comfort when your foot has been cramped all day."

"Someone who is already professionally oriented and is doing a specific exercise that involves separating fingers and can't learn it , there may be a specific and transitory point of action, but very limited," he continues.

Asked if it's a trend , the expert thinks so, adding that it has increased "exponentially" following the emergence of minimalist footwear . "I would recommend promoting a minimalist shoe to the entire population, one that, for example, has a certain shape at the toe, but without the separators. The power of fashion is so absolute that it forces us to be ridiculous for fear of appearing so, and this habit has implications for our health ," he indicates.

He also differentiates between separators for the first and second toes and those for all five. "There is very little scientific evidence, and the studies that do exist only analyze those for the first toe," he explains. "The information that comes from social media comes from people with only limited knowledge of the subject, and that creates more confusion than the lack of information," he continues.

Regarding when they appeared, he confesses that they have been around forever: "There are cultures that have used them in metal or wood . You only have to remember grandmothers, who placed sponges between their toes because they already had deformities due to footwear and they relieved the chafing. What we understand by the toe separators that are currently in fashion, I would say that they began to spread from the 2000s onwards, as different brands came out . This implies that the very people who promote it also have a commercial interest , let's not fool ourselves. The problem is that it should not override population health."

In fact, he believes the device's biggest risk is misinformation . "We're following a trend where we all have to add things to our bodies, and pathologizing is never good . Not to mention the paradox of the system itself: we want to give our fingers freedom by using something that impedes their movement. Fingers have very different behaviors; the pressure isn't homogeneous; it depends on the exercise you're doing or the gait cycle," he notes.

"Generic toe separators, in my opinion, have little or no therapeutic effect."

This isn't the only point he complains about: "It's said to have a vascular benefit when much of the foot's venous return is based on the toes' ability to move. Rather, it creates a tourniquet effect because there's no great sizing; it won't be able to adapt to small, long, or fat toes. Separating the toes doesn't mean it's doing it correctly ."

For his part, Víctor Alfaro Santafé , podiatrist and professor of biomechanics and podiatry, tells El Confidencial that podiatrists offer personalized toe separators as part of their treatments: " They must be made to measure and are not usually intended to separate all the toes, but rather to act on certain interdigital spaces when there are certain pathologies such as bunions ( to avoid rubbing between the first and second toes) or interdigital helomas . This type of silicone orthosis must be made by a professional."

"Generic toe separators, in my opinion, have little or no therapeutic effect . In fact, most of them are sold without any type of health control. It's an item that most podiatrists, or any other professional who is an expert in human gait, routinely recommend to our patients," he states. "They have been used for a long time in the world of aesthetics to separate toes for painting nails, a use for which they logically make sense. The problem is thinking that this generic item is going to improve foot health problems," he explains.

Thus, he emphasizes that "they have no beneficial effects on the foot." "A positive thing is to wear shoes with a proper fit and occasionally free your feet to perform certain activities barefoot in a protected environment. This can improve the intrinsic muscles of the foot and the mobility of the toes."

Regarding the improvement of what are commonly known as bunions , he says they should be corrected by performing specific exercises and, on certain occasions, using a custom insole that " improves load distribution on the foot to prevent them from spreading." Finally, he offers some advice: "If someone uses a separator and sees that one of their toes turns white or loses sensation, they should remove it immediately."