Toe spacers? What the Evidence Says About Their Biomechanical and Circulatory Impact

Introduction

In recent years, toe separators have gained popularity, especially in communities promoting a “foot liberation” philosophy. These devices, usually made of gel or silicone, claim to correct toe alignment and improve overall foot health. But do they really deliver on their promises? Or could they actually cause counterproductive structural, functional, and circulatory effects?

A recent study conducted by Podoactiva analyzed their use from an advanced biomechanical perspective, employing tools such as X-rays, pressure platforms, and infrared thermography. At TermoHuman, we especially highlight the value of thermography as a key technique to understand less visible but highly relevant physiological effects, such as changes in skin perfusion or potential circulatory blockages.

What Are toe separators o toe spacers?

Toe separators are devices designed to be inserted between the toes to keep them “aligned,” relieve discomfort associated with conditions such as bunions or claw toes, and theoretically improve load distribution.
While many of these claims sound logical, foot biomechanics are complex, and the effects of these interventions need to be analyzed with precision technology and a multidisciplinary approach.

X-Ray Analysis: What Happens Structurally?

Imaging analysis revealed an interesting finding: although toe separators do increase the space between toes, they simultaneously bring the metatarsals closer together, creating a shearing effect in the forefoot’s load-bearing area.
This effect can compromise delicate structures such as the interdigital neurovascular bundle, increasing the risk of conditions like Morton’s neuroma. In other words: what separates on top, compresses below.

Pressure Analysis: Do They Affect Gait?

Dynamic analysis on a pressure platform showed that using separators interferes with the third “rocker” phase of gait—the final propulsion phase where the toes should come together to generate an efficient push-off.
By preventing this action, sustained mechanical overload is placed on the heads of the second and third metatarsals, which can lead to medium-term pathologies. This alteration in gait pattern reflects a clear functional cost that is not always subjectively noticed by the user.

Thermography: The Key to Seeing What Can't Be Seen

Infrared thermography detects temperature variations on the skin’s surface, often linked to circulatory issues, inflammation, or nerve compression. In this study, a foot with a separator was compared to one without, revealing a significant temperature decrease in areas in contact with the device.
This thermal difference suggests a possible restriction in local blood flow, which could have important implications if the device is used over time. Some patients even showed a “tourniquet-like” effect, especially when the foot’s geometry did not adapt well to the separator, causing a color change (whitish toes): a clear sign of mild to moderate ischemia.
These kinds of observations are difficult to detect without a tool like infrared thermography, which has become a key non-invasive ally to identify these alterations before they become clinically evident.

Do They Affect Venous Return?

One of the most frequently repeated commercial claims is that separators “improve circulation.” However, from a physiological standpoint, this lacks foundation. Venous return is enabled by a structure called Lejars’ venous sole, located in the sole of the foot, not the toes.
Therefore, the use of separators neither activates nor enhances this physiological pump and may, in some cases, even limit peripheral microcirculation if excessive pressure is applied to the digital vessels.

Conclusions: Are They Worth Using?

The use of generic toe separators, without customization and professional supervision, does not appear to provide significant biomechanical benefits. On the contrary, they may alter pressure distribution, cause neurovascular compression, and reduce gait efficiency.
At TermoHuman, we emphasize the value of technologies like thermography to provide a real-time functional and physiological perspective, enabling early detection of warning signs such as thermal alterations, inflammation, or circulatory deficits that often go unnoticed.

Recommendations

• Promote active toe mobility, especially barefoot on soft surfaces (sand, grass).
• Avoid generic devices that are not adapted to the foot's morphology.
• Consult a professional if you wish to improve toe alignment or prevent deformities.
• Consider alternatives such as custom orthoses, specific exercises, or elastic insoles designed by podiatrists.
• Incorporate thermography as part of clinical analysis to optimize prevention and monitoring.

Reference:

• https://www.podoactiva.com/blog/separadores-de-dedos-realmente-benefician-la-salud-del-pie