Hallux Limitus: A Stiff Big Toe Joint

At first glance, there might not seem to be much in common between gardening, downhill skiing, plumbing, ballroom dancing, or playing catcher for a baseball team, but individuals who participate in these activities all have increased risk of a condition known as hallux limitus. As you will see, the primary reason for this is related to the amount of pressure the activities can place on the front of the foot.

We can provide treatment for this condition at our Indianapolis, IN office, but it is important for you to be able to understand the problem, characterized by a stiff big toe joint, and how we might address it for you.

Hallux Limitus Explained

Let’s start with a quick look at relevant foot anatomy, especially your toes. A toe bone can be known as a phalanx—which is actually a reference to the rows of Greek soldiers standing in formation—but the big one is specifically known as the hallux. The joint where the hallux (or any phalanx) meets the foot is known as the metatarsophalangeal (MTP) joint. In a normal, healthy case, this joint has a range of about eighty-to-ninety degrees of motion, with at least thirty degrees being necessary for walking.

The MTP joint is where hallux limitus develops. Of course, if you are familiar with bunions, you will realize they form at this location as well. Typically, a bunion will drive the MTP joint out of alignment so the hallux tilts toward the 2nd toe. Hallux limitus leads to a loss of motion in the big toe. This loss can happen at a rate of about five degrees per year.

So how does this occur? Well, it goes back to those people who garden, downhill ski, and ballroom dance. Activities that forced the big toe joint to bend at its maximum range of motion lead to excessive pressure and force loads on the front of the foot and, more specifically, on that first MTP joint. As the foot endures these forces, the body will respond by building up bone tissue around the joint, leading to restricted motion.

In the sports medicine field, a hallux limitus deformity is also called a turf toe. If you haven’t had a toe injury, it might not sound like a big deal, but consider the case of legendary Pittsburgh Steeler linebacker Jack Lambert. Lambert has a reputation as being one of the toughest football players of all-time. This Hall-of-Fame linebacker was instrumental in the success of the Pittsburg Steelers during the 1970s. On many occasions, he played through a variety of physical ailments. The one that ended his football career, though, was hallux limitus – a toe injury.

This is a very debilitating injury – one that can take away your ability to do favorite activities like downhill skiing or playing baseball, picking up a grandchild, or even performing your job (if you spend lots of time in a crouched position). As such, it’s important to recognize symptoms so it can be treated early. These include:

  • An observable bump on the top of your big toe’s MTP joint
  • Stiffness and pain at the base of your big toe, especially while squatting, running, or walking
  • Stiffness and pain brought on by damp, cold weather
  • Swelling and inflammation around this joint

Hallux Limitus Treatment

Early treatment for hallux limitus is ideal, since we may be able to actually save the joint (instead of needing to fuse it). Generally speaking, we can either correct (change the foot) or protect (change the environment) with a condition like this. “Change the environment” is a matter of using conservative treatment methods to relieve symptoms and prevent the condition from progressing. In this case, some options we may use are carbon-fiber plates, steroid injections, or even certain stiff-soled, rocker bottom  shoes which can keep excessive pressure off the front of your foot.

When it comes to “changing the foot,” we are looking at surgical procedures. This condition progressively worsens when left untreated, so it is especially important to come in for early treatment. If you do, we can potentially clean up any bone spurs and save the joint’s mobility. Putting off treatment can increase the likelihood that a bone fusion procedure might be your only option.

Don’t put off treatment for hallux limitus! Instead, simply give us a call at (317) 545-0505 or take advantage of our online form to request your appointment with our Indianapolis, IN office today.