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HALLUX LIMITUS/ RIGIDUS (TURF TOE)

Hallux limitus is reduced motion in the first metatarsophalangeal (big toe) joint.  When hallux limitus progresses and motion ceases to exist, the toe becomes rigid and is known as hallux rigidus. 

A delicate balance exists between the first metatarsophalangeal joint (where the rest of the foot joins the big toe), 1^st metatarsal (big toe), sesamoids (pebble-sized bones under the 1^st metatarsal) and their tendons.  Several conditions contribute to disruption of this part of the foot – hallux valgus, failed bunion surgery, overpronating and rheumatoid arthritis.

Turf toe is a common injury in football and soccer, as well as having a relationship to sports played on artificial surfaces.  About 50% of those who incur the injury still have persistent pain at 5-year follow-up.

Other names or similar foot conditions:

• Arthrosis of the first MTP joint
• Turf toe

Symptoms:

• Pain deep in the joint and aggravated when walking barefoot and by rising on the toes
• Reduced ROM compared to the first MTP joint on the other foot

Signs to look for:

• Pain deep in the joint and aggravated when walking barefoot and by rising on the toes
• Reduced ROM compared to the first MTP joint on the other foot

Possible Causes:

• Concurrent hallux valgus
• Failed bunion surgery
• Rheumatoid arthritis
• Overpronating foot
• Sports injury

Goals:

• Modify shoes to accommodate rigid joint
• Reduce motion, limit dorsiflexion at the first MTP joint
• Reduce pressure at the joint to eliminate callusing
• Relieve lateral forces at the MTP joint that accompany pronation
• Reduce foot shearing

Solutions:

Arch Supports:

• Bio-Orthotics Winstep or Sundance exercising support with metatarsal lift

• Lower and thinner arch support with longitudinal and metatarsal support, such as the Bio-Orthotics Journey or Silhouette, for use when shoes cannot accommodate the Winstep or Sundance exercising support

• Morton’s extension placed under arch supports

• Extra depth shoes with extended steel shank, firm heel counter, rocker sole and high toe

• Stiff sole or Morton’s extension placed in shoe

• Use shoes with titanium springs for exercising

• MBT physiological footwear

Other: 

Spot stretching at toe with ball and ring stretcher

Activities:

• Avoid activities that produce symptoms until the symptoms recede

• Rotate weight bearing exercises, such as walking or jogging, with non-weight bearing exercising, such as swimming or bicycling

This information does not constitute a diagnosis of your condition and does not take the place of a doctor’s care.  The information has been compiled from sources available to the general public and referenced below.  Copyright 2005 Carole Romig

Sources  Image:  T. Michaud, Foot Orthoses  Text: B. Meanwell, CPed, D. Janisse, CPed, Introduction to Pedorthics, I. Alexander:  The Foot: Exam & Diag