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Hallux Rigidus

Hallux Rigidus was first described in 1887 by Davies-Colley, in referring to a plantarflexed posture of the phalanx relative to the midtarsal head. Hallux Rigidus is a painful condition characterized by a limited range of motion in the first metatarsalphalangeal joint, mainly when being dorsiflexed. Common causes of hallux rigidus are faulty (biomechanics) and structural abnormalities of the foot that lead to joint limitations caused by degenerative arthrosis of the MTPJ, there are many conditions however that can also result in hallux limitus such as gout, psoriatic or rheumatoid arthritis.

Symptoms

Typically the patient presents with pain and stiffness as well as inflammation around the joint usually at the dorsal aspect to start, and often when running or squatting, as the condition progresses untreated the patient may have pain, even during rest, also may exhibit pain in the knee, hip or lower back due to compensations during the gait cycle.

Treatment Goals

Treatment of the Hallux Rigidus revolves around restricting the 1st MPJ range of motion and ultimately offloading the MPJ.

Orthotic Treatment

  1. Patient must be casted in subtalar neutral, with the midtarsal joint locked.
  2. If there is a pronation factor an extrinsic rearfoot post must be added with a degree of 4* to 6*
  3. Minimum fill cast dressing.
  4. Add a Morton Extension, it will reduce dorsal excursion of the hallux and prevent jamming against the first MPJ.
  5. In extreme cases a rigid shell extension may be necessary.
  6. For more help call for professional Consultation.