If the plantarflexors (gastrocnemius and soleus) are weak or hypotonic, then the strong plantarflexion action needed for push-off will be weak as well. This is more noticeable when walking up an incline.
When the plantarflexors are strained or hypertonic, heel strike is painful and weak. The inability to counter dorsiflexion may result in a toe strike or foot drop. Unilateral dysfunction in the plantarflexors result in uneven gait. [1] (The step length, when the stance leg is the leg with the weak planterflexors, and the contralateral limb is swinging, is shorter than the step length when the unaffected limb is the stance leg and the affected limb is swinging). See video below.
Turf toe usually results from severe hyperextension of the first metatarsophalangeal (MTP) joint. The injury can occur in a variety of ways including (but not limited to) automobile accidents, chronic overuse (e.g. in ballet dancers) and sports injuries. Turf toe can be significantly disabling both in the acute period and in the long-term. Physical examination findings include a dorsally swollen, tender first MTP. In addition, range of motion is painful and limited. Weight bearing is usually tolerated with some pain but in more severe injuries, weight bearing may be accompanied by a limp or not tolerated at all. [2] Antalgic gait is typically observed with turf toe injury. Step length is diminished as a result of poor weight bearing capabilities. The step length, when the stance leg is the leg with the injured toe, and the contralateral limb is swinging, is shorter than the step length when the unaffected limb is the stance leg and the affected limb is swinging.
Reference 1: Goodwin J. Touch & Movement: Palpation and Kinesiology for Massage Therapists. 2011. Cengage Learning. Chapter 3, Gait Assessment. Pg 115., Reference 2: Thordarson D B (and other series editors). Orthopaedic Surgery Essentials. Foot and Ankle. 2004. Lippincott Williams & Wilkins Publishers. Chapter 11, Degenerative Joint Disease/Forefoot Arthritis. Pg 239.
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