Understanding hallux limitus & rigidus
Hallux limitus means restricted movement at the big toe joint, and hallux rigidus is the more advanced form where movement is severely limited. Arthritic change within the joint is usually involved.
As the joint stiffens, you begin to roll off the side of the foot instead of over the toe. That compensation is why people often present with pain elsewhere, in the outer forefoot, the knee or even the hip.
Signs you might notice
- Pain and stiffness at the base of the big toe
- Difficulty bending the toe upwards
- A bony lump on top of the joint
- Pain pushing off when walking or running
- Wear on the outer edge of your shoes
Common contributing factors
- Osteoarthritic change within the joint
- Previous injury to the toe
- Foot structure that limits joint mechanics
- Occupations or sports demanding repeated toe extension
- Long term altered loading patterns
How we assess and treat it
We measure how much movement the joint has, assess the arthritic change and use pressure mapping to see how you are compensating. That compensation is often causing more trouble than the toe itself.
Treatment aims to maintain the movement available, reduce pain within the joint and manage the knock on effects elsewhere.
- Joint mobilisation and hands-on therapy
- Footwear advice, particularly sole stiffness and rocker
- Orthotic therapy to manage push off mechanics
- Strength and mobility work through the foot
- Referral for a surgical opinion where appropriate
Common questions
Can the stiffness be reversed?
Arthritic change itself cannot be undone, but people are often surprised how much comfort and function can be regained by improving what movement remains and changing how you load the joint.
Why does my knee hurt too?
Because when the big toe cannot extend, you roll off the foot differently and that changes the load through the whole leg. It is a good example of why we assess the whole chain.
Are stiff soled shoes really helpful?
Yes, often markedly so. A stiffer sole reduces how much the joint has to bend, which can reduce pain immediately.