What is the ‘too many toes’ sign?

The term ‘too many toes sign’ is widely used when looking at someone standing or during a gait analysis. It does not mean that someone has more than five toes on their foot.

When someone is standing or walking and you are watching them from behind, you can typically see one or two of the smaller toes. If you see more than that, then that is positive for the too many toes sign.

In the video screen grab above you can hypothetically see the three smaller toes of the right foot, so this could be considered a minor case of the ‘too many toes sign’. Sometimes you can see all five toes when observing from behind, which would count as a major case of the sign.

The ‘too many toes sign’ does not really have any clinical significance or is a medical diagnosis of anything. It simply means that there is more transverse plane movement of the foot and the there is a lot of abduction of the forefoot during gait. This typically happens when there is some ‘overpronation’ going on for any number of reasons.

The term or phrase is often used by clinicians when discussing their gait with a patient and they comment on the observation.

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