Hallux (big toe) rigidus (rigidity or stiffness) is a condition that effects the joint located at the base of the big toe. It causes pain and stiffness in the big toe joint (1st metatarsalphalangeal joint MPJ), and with time, it gets increasingly harder to bend the toe. It is a progressive condition limiting the toe’s motion more and more as time goes on.
In its earlier stage, when the motion of the big toe is only somewhat limited, the condition is called hallux limitus. But as the problem advances, the toe’s range of motion gradually decreases until it potentially reaches the end stage of rigidus, in which the big toe becomes stiff and motion becomes severely restricted. Functionally this can be very disabling as loss of motion at the MPJ can alter the way we walk effecting stride length, limb position during terminal stance, and alter lower extremity flexibility. Hallux limitus/rigidus can inhibit our ability to stoop down, climb, or even make it uncomfortable to stand.
Common causes of hallux rigidus are faulty biomechanics and structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint. Osteoarthritis of the big toe joint often develops in people who have musculoskeletal conditions that change the way their foot and big toe functions. Individuals who have fallen arches or excessive pronation (flattening of the arch) are most susceptible to developing hallux rigidus.
Some people are prone to developing hallux rigidus due to inheriting a specific foot type. Excessive pronation associated with flat feet and internal rotation of the lower leg has been linked to the development of hallux limitus. Hallux rigidus can also result from an injury, such as stubbing your toe or from inflammatory diseases, such as rheumatoid arthritis or gout.
In other cases, hallux limitus/rigidus is associated with overuse activities or jobs that increase the stress on the big toe joint especially with jobs that require a lot of stooping or squatting. The most common cause of hallux limitus/rigidus is trauma, both acute trauma, and repetitive microtrauma. Athletes are susceptible to developing hallux limitus/rigidus especially those involved in sporting activities such as runners (sprinters), football (linemen/turf toe), rugby (scrum), basketball, soccer/volleyball (especially when played barefoot in sand), or any sport that requires squatting, such as the catcher’s position in baseball. Footwear can also play a role in developing hallux limitus/rigidus, especially when using a soft shoe on a hard surface.
Sole Remedy can address the inflammation, pain, and stiffness associated with hallux limitus/rigidus with appropriate shoe modifications and orthotic intervention to improve foot function.
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