Hallux Rigidus Treatment

Hallux Rigidus Treatment

Hallux Rigidus, commonly called ‘Stiff Big Toe’, reduces your range of motion and can ultimately affect how you walk.

About the condition

What is Hallux Rigidus?

Commonly referred to as ‘Stiff Big Toe’, Hallux Rigidus is a degenerative condition that leads to a reduced range of motion in the first metatarsophalangeal joint (MTP) or your big toe.

This can impair your gait, especially the propulsion phase or as you toe off. Over time you gradually lose movement in your big toe.

At the base of the first MTP is usually where the degenerative arthritis is found. The ends of the bones are covered with articular cartilage, a shiny covering to protect the ends of the bones within the joint. As this covering wears, degeneration occurs until bone is against bone. Bone spurs develop as part of this degenerative process and movement decreases.

Normal range of motion is approximately 70 degrees of extension. We need 45-65 degrees to be able to walk without compromise or compensation.

Weight bearing X-rays are often required to examine the joint.

Hattrup and Johnson classification:

Treatment

At Vitalis Physiotherapy, our specialised treatment of Hallux Rigidus aims to:

Prevention

Prevent further damage

Improve foot function

Prevention

Prevent change in gait

Classification

Grade 0

  • Dorsiflexion 40-60°
  • Normal radiography
  • No pain
Classification

Grade 1

  • Dorsiflexion 30-40°
  • Dorsal osteophytes
  • Minimal/ no other joint changes
Classification

Grade 2

  • Dorsiflexion 10-30°
  • Mild to moderate joint narrowing or sclerosis
  • Osteophytes
Classification

Grade 3

  • Dorsiflexion less than 10°
  • Severe radiographic changes
  • Constant moderate to severe pain at extremities
Classification

Grade 4

  • Stiff joint
  • Severe changes with loose bodies and osteochondritis dissecans
Symptoms

What are the symptoms?

As the disorder progresses:

  • Pain, stiffness around the base of the big toe
  • Swelling around the joint
  • Pain aggravated by walking, running or walking up hills
  • You may be able to palpate a “new prominence” around the joint compared to the other side
  • Pain aggravated by cold, damp weather
  • Difficulty with squatting
  • Pain even a rest
  • Difficulty wearing shoes due to bone spur development
  • Changes to how you walk may affect you knee, hip or lower back
  • Limping due to pain
Treatment

Treatment for Hallux Rigidus

In many cases cases early treatment is crucial to prevent or postpone surgery.

If conservative management fails then surgery is the only option to eliminate or reduce pain.

  • Joint mobilisation
  • Soft tissue release
  • TECAR therapy
  • Custom Foot Orthoticscan help improve foot function
  • Shockwave Therapy
  • Shoe modifications such as a larger toe box or a rocker bottom may be recommended
  • Tailored exercise program

Need Help?

Are you suffering from painful Hallux Rigidus, or looking for a physiotherapist around me? Contact Vitalis Physiotherapy now to book in your treatment. Call our friendly team on 0410 559 856. We’d love to help.