Physiotherapy for Hallux Rigidus – Arthritis usually targets the foot at the base of the big toe. The joint at the base of the big toe is called the metatarsophalangeal or MTP joint. This joint plays an important role in bending the toe with every step you make to allow for proper movement. However, if the MTP joint begins to stiffen, walking or even standing can be very painful.
Every joint in the body, including the MTP joint, is covered with a smooth articular cartilage. Damage to the cartilage can expose the bones it covers and cause them to rub against each other. This may result in the formation of a bone spur or abnormal growth at the top of the affected bone. The growth may inhibit the bone from bending enough to let you walk without any pain or discomfort. This causes a stiff big toe, or hallux rigidus.
Hallux rigidus most commonly occurs in adults between the ages of 30-60 years. The exact cause of the condition, and why it is only seen in some people, is still not known. Hallux rigidus may result from an injury that damages the articular cartilage around the toe joint or from an abnormal foot anatomy that encourages excessive stress on the joint.
Signs and symptoms of hallux rigidus include:
- Swelling around the joint
- Pain around the joint when you walk
- A bump similar to a callus or bunion on the top of the foot
- Stiffness in the big toe, causing the person to have difficulty walking
In mild cases, early non-surgical treatment may help prevent the need for surgery later on. Treatment options for mild hallux rigidus include:
You can take over-the-counter NSAIDs such as ibuprofen to reduce pain and inflammation
- Shoe modification
Wear proper-fitting shoes that apply equal pressure to the whole foot. Wear large toe box footwear, that is shoes with a large space at the front of them for your toes. Large toe box footwear prevents extensive pressure being applied to the toe. Your health care practitioner may also recommend rocker-bottom or stiff sole shoes
- Orthotic devices
Custom-made orthotic devices may enhance foot function. At Happy Physio we offer Gait Scan assessments that utilise the latest technologies to assess the shape and behaviour of your foot. The Gait Scan is essential in determining exactly how your foot moves and is shaped, and subsequently determining if orthotics are right for you.
- Injection therapy
Corticosteroids injections may help reduce pain and inflammation
Ultrasound therapy and other physiotherapy methods suggested by your health care practitioner may help relieve symptoms of hallux rigidus
For severe and complicated cases, surgery may be the only treatment that could heal your foot.
Exercises for hallux rigidus
Physiotherapy involves the implementation of simple exercises into your routine as a form of treatment. Sometimes exercises provide temporary relief from the symptoms of hallux rigidus and can improve your wellbeing. By consulting a physiotherapist at Happy Physio you can determine which exercise(s) will suit you best and discuss your individual situation, goals and condition.
- Extension exercise
This exercise will help restore the range of motion of the affected joint and help to reduce pain. Keep your toe in its proper position and bend your toe up and down using your hands. Cross the injured foot over the other leg’s knee and bend the toe up and down using your hands. Hold on to each bend for 30 seconds.
- Flexibility exercise
Cross the affected foot over the other knee and gently grab the affected foot behind the toe joint using your opposite hand. Make sure your foot is held stationary throughout the whole exercise. Use your other hand to gently pull the big toe away from the foot. Hold this position and rotate the toe gently in a clockwise or anticlockwise direction.
- Dorsiflexion exercise
Cross the affected foot over the other knee and bend the toe backwards as much as possible using your hand, without causing any pain. Hold this position for 20-30 seconds and then relax. You can also bend your toe back and forth without using your hands before initiating another rep. Perform this exercise three times a day or as directed by your physiotherapist.
This is a range of motion exercise, which is to be performed without wearing shoes. Without using your hands, spread your toe as wide as possible and then press them together. Hold onto each position for 10-15 seconds and repeat as directed by your physiotherapist. If the exercise does not seem to be as effective as required, you may use your hands to grab the ends of the toes and pull them away from the adjacent toes.
It is difficult to treat hallux rigidus on your own and Happy Physio understand the uncomfortable and interrupting nature of the condition. Please do not hesitate to contact our friendly administration team on (08) 9272 7359 to discuss how we can help you get back to feeling happy and healthy.