Davis Therapeutics of San Francisco

Hallux Rigidus (Stiff Big Toe)

Hallux Rigidus / Limitus (Stiff big toe)

Hallux Rigidus / Limitus (Stiff big toe)

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In these conditions, the big toe will not bend upwards as the foot propels over it. Not only can it be painful, but compensations made in gait to avoid the pain can cause repercussions throughout the muscular skeleton system. Hallux limitus allows for some movement but the movement can be just as or more painful. Treatment for hallux rigidus involves devices or shoe modifications that inhibit the need for motion in the big toe joint during gait, and treatment for hallux limitus does the opposite, it facilitates motion in the big toe joint, provided the joint has not yet spontaneously fused as it is in hallux rigidus. The root cause of these disorders is excessive pronation.

$ Retail or Internet Store

  • Acquire shoes with stiff, thick soles, preferably shoes where the sole is thicker under the ball of the foot than it is under the toes. This allows the foot to roll forward without bending the toes. These are referred to as rocker soles and there are several ready-made shoes that have them, to one degree or another.

$$ Pedorthist or Other Foot Care Specialist

  • Along with the rocker soles, a thin carbon fiber plate can be inserted into shoes, under the insole, to make the shoe stiffer.

$$$ Pedorthist

  • Nearly any shoe can be modified (orthopedic alteration) to incorporate custom rocker soles. Even if the problem is on one side, the rockers must be put on both shoes because it involves elevating the shoes about ½”.

$$$ Pedorthist or Other Foot Care Specialist

  • Custom Orthotic Devices. Since excessive pronation is the root cause of the problem, it stands to reason that controlling the pronation would effectively slow down or stop the progression of hallux limitus into hallux rigidus. Once the big toe joint (1st metatarsal phalangeal joint [MPJ]) has become rigid, supporting the joint (lifting it) will diminish forces to the area and reduce pain. To lift the joint with hallux limitus could precipitate hallux rigidus, so it should not be done. This amount of control and specificity can only be accomplished with custom orthotic devices.