Hallux Limitus/Rigidus
Limited motion of the great toe joint. Hallux is the great toe. The joint is at the base of the great toe. Degenerative joint disease/arthritis of the great toe joint. Thickening enlargement of the bones of the joint and narrowing of the great toe joint, erosion of the cartilage. The arthritis of the joint is progressive. As the motion decreases from the normal to where it is first called Hallux Limitus and later is called Hallux Rigidus with less than 10 degrees of motion of the great toe joint of dorsiflexion (upward motion). The great toe joint can become progressively stiffer.
Causes
Common causes of the decreased motion of the great toe joint are irregular biomechanics, abnormal structure of the foot, trauma, arthritis. With the foot biomechanics being irregular this causes increased pronation leading to hallux limitus/rigidus. One’s foot structure is inherited and therefore Hallux Limitus/Rigidus can run in the family. Trauma or stress to the big toe joint from an accident from sports or trauma or one’s constant foot position in performing their occupation. Other causes are various arthritides like gout, rheumatoid or osteoarthritis .
Symptoms
Limited motion of the joint
Pain
Stiff joint
Swelling enlargement of the bone around the joint
Discomfort with activities like running, squatting
Lack of ability to wear high heel shoes
Bone overgrowth or spurs causing limited motion and pain from shoe pressure
Altered gait leading to foot, knee, hip or back pain
Diagnosis
Examining the biomechanics of the foot and joint-range of motion
Xrays
Treatment
Lower the shoe heel height
Rocker shoes of the forefoot eg. stiff running shoes like Hoka running shoes or New Balance More. Regular shoes like Dansko, Naot, Wolky
Stretching the shoe over the joint area
Stiff shank of the sole
Custom orthotics with possible modifications like a 1st metatarsal cutback or Morton’s Extension
Anti-inflammatories
Injection into the joint
Physiotherapy-Manipulation
Surgery
