Stiffness in big toe. This is perhaps the simplest description of hallux rigidus, a condition that restricts runners form heavy activity or completely side-lines them from activity. Hallux rigidus limits the dorsiflexion of the big toe at the MTP joint, resulting in pain during running or walking.
In response to the pain in your big toe, you tend to adjust your running posture. The effects of this change are usually felt in your hips, knees and lower back in form of fatigue, pain or stress.
Symptoms of Hallux Rigidus
- Stiffness and pain at the metatarsophalangeal joint (MTP joint) which gets worse when running or walking.
- Inflammation or swelling on the big toe.
- As the condition gets worse, the big toe might completely lose its mobility and cause you to limb.
- With time the pain on the big toe becomes more frequent.
- The skin around the joint becomes tender to touch
- In serious cases a lump may form at the joint due to degeneration or excessive bone growth
- What follows is pain on the knees, hip and lower back as a result of the change in your running or walking posture.
Causes of Hallux Rigidus
Hallux rigidus cannot be attributed to any single cause. However there’re certain risk factors that increase your chances of suffering this condition. These include:
- Injury. When walking or running, you may hit your big toe or sprain the joint. This can cause hallux rigidus.
- Overuse. Overpronation causes regular rolling of the foot inwards which increases stress on the MTP joint. Repeated strain on the joint causes stiffness on the big toe. Runners are at a greater risk of developing hallux rigidus because of their tendency to stress the MTP joint. It is also common in people or workers who must squat regularly.
- Inflammatory conditions. Hallux rigidus can also be associated with some inflammatory illnesses like rheumatoid arthritis, osteoarthritis and gout
- Family genetics. People may inherit certain walking styles and foot types that are prone to hallux rigidus.
- Gender. Recent studies have shown that women are more likely to suffer from this condition.
- Structure of your foot. People with abnormally long first metatarsal bone, risk suffering hallux rigidus.
Hallux rigidus can develop into a serious problem if not treated early. If you experience the above symptoms, this is the best time to see your doctor for a diagnosis. Normally, your doctor will examine the condition of the foot and check the extent of stiffness in the toe.
An X-ray may be used to determine the extent of arthritis and check for any other abnormalities in the joint.
Treatment for Hallux Rigidus
Early treatments for hallux rigidus are meant to ease pain and inflammation and delay the necessity for a surgery. These remedies include:
- Choosing the correct running shoes. The best rubbing shoes for hallux rigidus should have a wide to box and a stiff, rocker bottom. This will protect your big toe from excessive bending.
- Rest. Suspend activities that strain the joint such running and jumping. You can substitute with low-impact activities such as cycling and swimming until the pain and inflammation subsides.
- Medication. Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
- Injection. A corticosteroid injection may be prescribed to ease pain and reduce inflammation.
- Physical therapy. Physical therapy can help increase movement at the joint and provide a short-term relief.
- Use of Orthotics. Orthotics will provide necessary support to the bones to prevent the big toe from bending.
Related: Orthotics for Hallux Rigidus
Hallux Rigidus Surgery
Surgery is only recommended when other treatments fail to alleviate symptoms of hallux rigidus. Depending on the severity of the condition, your doctor might recommend any of the following surgeries.
Cheilectomy is meant for treating mild or moderate hallux rigidus. In this procedure, the bone spur is shaved to give more room for the toe to bend. The aim is to alleviate pain experienced when pushing your toe off the ground. Cheilectomy is conservative approach since it does not affect joint stability or joint motion.
Sometimes cheilectomy is performed together with osteotomy.
When the joint is severely damaged, an arthrodesis is done to fix the two bones together. The two bones are joined with plates or screws after removing the damaged cartilage. This provides a permanent solution to the pain and arthritis.
However, this procedure restricts of motion of the big toe.
This is entirely a joint implant where a portion of the damaged bone is removed and replaced with a soft tissue from your foot to allow motion. This is especially done in moderate to severe cases of hallux rigidus where patients want to retain motion of their big toe.
Although the procedure is effective, it is not very reliable.
In arthroplasty one or both joints are removed and replaced with artificial joints (either plastic or metal). While this procedure can relieve pain and maintain joint motion, it is usually not recommended by most surgeons. Its disadvantages include.
- It can cause infection
- Can cause instability of the soft tissue
- Such an implant might fail
Benefits of Good Running Shoes on Hallux Rigidus
As runner, you want to keep running without experiencing pain on your big toe. So, you require a high quality running shoe for hallux rigidus to enable you relieve excessive pressure on your big toe.
The ideal running shoe for hallux rigidus should have a rocker bottom and a stiff sole to keep your big toe from bending. In addition, proper orthotics for hallux rigidus will help prevent excessive bending of the big toe. When you alleviate excessive pressure on your big toe, you reduce chances of suffering from hallux rigidus.
Here is my list of recommended best running shoes for hallux rigidus.
- Altra Torin 3.0 Running Shoes
- Brooks Adrenaline GTS 17
- Hoka One One Clifton 4 Running Shoes
- Altra Instinct 3.0 Running Shoe
- Hoka One One Bondi 5 Running Shoes
Running with hallux rigidus can be extremely painful or even completely impossible. However, it is possible to treat the condition using home treatments and wearing the recommended running shoes.
If home remedies fail to alleviate the symptoms, your doctor might recommend some form surgery to help in the recovery.