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A Hallux Rigidus is highly likely to slowly deteriorate over time if it goes untreated, with continued deterioration in range of motion and increased pain levels.
We recommend trying footwear alterations, insoles and Physical Therapy exercises to reduce the speed of change within the joint.
Surgery for most conditions should be avoided due to the associated risks. Usually, with Hallux Rigidus, surgery is only recommended for cases with Grade 2-4 changes within the 1st MTP that have failed at least 3 months of Physical Therapy that included exercises, advice on footwear and injection and insoles.
Hallux Rigidus impacts the push-off phase of gait as, during this part of the gait cycle, 60-70% of your body weight should go through your big toe. However, if your big toe cannot extend due to Hallux Rigidus, patients typically adapt to an early heel lift, limiting the push-off phase.
Hallux Rigidus is a condition we try to manage conservatively through Physical Therapy, footwear and insoles. It can be cured through surgery, for which there are numerous forms but a relatively high recurrence rate.
Hallux Rigidus can cause a red and swollen appearance to the big toe joint that is worse after activity.
If you have Hallux Rigidus but do not have any symptoms, then you can continue running. Suppose you have no pain when running but mild pain afterwards. In that case, we recommend continuing to run while ensuring you have the optimal footwear and seeing a Physical Therapist for mobility and strengthening exercises.
If you have constant pain that worsens when running, we recommend you stop running and see a foot specialist for a consultation.
If you have Hallux Rigidus and it is pain-free when playing tennis, you can generally continue to play. We recommend purchasing a stiff-soled tennis shoe when playing.
We recommend stopping this activity if you have moderate to severe big toe pain during or after playing tennis.
We recommend gentle non-impact exercise for those with Hallux Rigidus. Ideally, this would consist of cycling, elliptical or swimming but if this is not an option, then short frequent walks are recommended of 15-20 minutes rather than walks of 1 hour or more.
Yes, you can cycle with Hallux Rigidus due to the non-impact nature of the activity; it is doubtful to exacerbate the symptoms of Hallux Rigidus.
We recommend cycling with cleats as the firm soles prevent significant toe extension and staying in the saddle with a high cadence to reduce the force placed on the forefoot.
Generally, sandals are not recommended for Hallux Rigidus as they lack the support of a trainer, resulting in an overload of the big toe joint. However, Birkenstocks are a highly recommended brand that offers insole support and supportive strapping that can reduce the pressure on the big toe.