Hallux Limitus/Rigidus

Hallux Limitus/Rigidus – Hallux is the medical term for your big toe. Your big toe is one of the most important parts of your body, as it provides propulsive force during gait. Your big toe should have between 50 and 90 degrees of extension—also known as dorsiflexion—if it is healthy and injury-free. This movement should be smooth and pain-free. A dysfunctional big toe will cause other parts of your body, especially the joints and tissues of your lower extremity, to compensate when you walk or run, which places increased strain on these structures and may, over time, cause pain and fatigue.
Hallux limitus is the term podiatrists use to describe loss of motion in your big toe joint. The metatarsophalangeal (MTP), joint of your big toe is the structure affected by this problem. Your first MTP joint is the location where your big toe connects to your first metatarsal bone—a long, thin bone that spans your mid-foot and forefoot.
Hallux rigidus is considered to be the end stage of hallux limitus, or a state in which your ability to create motion in your big toe is lost or severely restricted. Hallux rigidus may lead to long-term damage of your first MTP joint, and it usually involves erosion of your joint cartilage and the development of osteoarthritis, or degenerative joint disease. Hallux rigidus in which your big toe becomes stiff and immobile due to the partial fusion of your involved bones.

Hallux Limitus/Rigidus – are often considered idiopathic, or caused by unknown factors, but certain known factors may contribute too. Possible causes of Hallux Limitus/Rigidus include:

  • Trauma
  • Both can be associated with arch disorders
  • Excessive pronation (inward rolling of foot – flat feet/ fallen arches)
  • Genetics
  • Rheumatoid arthritis, gout, or other inflammatory diseases
  • Overuse
  • Poorly fitted footwear – especially tight, restrictive footwear

Symptoms:

  • Pain and stiffness when moving your big toe
  • Pain in your affected area when walking, running, or squatting
  • Pain and stiffness brought on by cold, damp weather
  • Swelling and inflammation in or near your first MTP joint
  • Limping or compensating during gait
  • Pain in your other lower extremity joints as well as your low back or knees 

Treatment Options:

  • Wear appropriate shoes with adequate space in the toe area to move your toes, make sure they can be well fastened too
  • Daily stretches, such as the toe extensor
  • Diet that includes anti-inflammatory foods such as whole foods, berries, nuts, fruit and veg, also reducing high fat/sugar foods too
  • Orthotic insoles can be helpful too. Some adaptations can be made to allow the toe joint to move through gait
  • Reduce risk factors for other complications (ie: reduce pressure on skin – callus/corns)
  • Surgery as a last resort

The extent to which non-surgical treatment can alleviate Hallux Limitus/Rigidus depends on your ability to move your big toe in two directions: away from your second toe (abduction) and upward (dorsiflexion).

 

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