Most Common Running Injuries: Part 3 of 4 - Hallux Limitus

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This series will explore the most common running injuries, their treatment, and prevention. In this entry, Hallux Limitus.
What is Hallux Limitus?

The 3rd most common running injury is called Hallux Limitus. The term hallux limitus is Latin with Hallux referring to the big toe and Limitus meaning decreased or limited motion of the joint. So, put together, there is limited motion in the big toe joint.

Symptoms:

  • Limitation of motion of the big toe joint

  • Swelling

  • Stiffness in big toe

  • Bone mass or Bump on top of the big toe

  • Bone spurs

  • Skin irritation from the top of the shoe

  • Compensation elsewhere in the body for the lack of motion that is needed for walking

  • Cannot bend or push off from the big toe so have a tendancy to put more pressures on the outside part of your foot causing pain on the outside of the foot

Common Causes:

  • repetitive trauma causing small bone spurs

  • injury

  • inherited foot structure

Treatment:

  • Custom orthotics to equalize pressure: a cut out in made in the orthotic under submet 1 to allow and increase motion of the big toe

  • NSAIDS: anti-inflammatory (such as acetaminophen)

  • Surgery to clean the joint and remove spurs

Recommendation: The best non surgical treatment for Hallux Limitus, in addition to anti-inflammatory medication, is custom orthotics. There are 2 main reasons for this is:

  1. They help increase available range of motion within the first metatarsal phalangeal joint by altering and improving mal-alignment and improper biomechanics.

  2. Prevents compensation which can lead to additional foot trauma and cause other injuries.

The most common orthotic modification is something referred to as a kinetic wedge/ submet 1 cut out.  However, for more advanced or end stage hallux limitus (usually termed hallux rigidus at this stage), restriction of motion is necessary with something called a Morton's extension.  Either way, orthotic therapy is critical to addressing faulty mechanics and attempting to eliminate pain while maintaining activity levels.

Common Running Injuries: Part 1 of 4 - Stress Fracture can be found here.

Common Running Injuries: Part 2 of 4 - Plantar Fasciitis can be found here.

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