Condition: Hallux Limitus/Hallux Rigidus
Hallux is the medical term for the big toe.
Hallux limitus is the medical term for progressive condition where the big toe is not able to bend up satisfactorily at the joint where the toe attached to the foot.
Over time the condition may progress and becomes more severe and the toe is almost not able to bend up and becomes stiff and it is named Hallux rigidus.
During the 2001-2002 National Basketball Association 2002 basketball star Shaquille O'Neal developed pain of the right big toe. At the end of the NBA season 2001-2002 he did not play 10 games with the Los Angeles Lakers because of a right big toe pain. He was diagnosed having limited range of motion of the big toe joint and arthritic joint. (Hallux limitus).
He was treated with anti inflammatory medications to relief the pain and the inflammation in the joint. Unfortunately, he had upset stomach from the medication. His pain did not affected his performance on the court at the NBA playoffs and he was elected as the most valuable player of the NBA finals 2001-2002.
Dr. Robert Mohr (doctor of podiatric medicine at the UCLA Medical Center in Los Angeles) evaluated Shaq and he found that he was able to bend the big toe approximately 30 degrees. Dr. Mohr explained to reporters that patients need about approximately 60-80 degrees of motion for athletic activities.
Mr. O’Neal elected to have elective foot surgery.
During the 45 minute outpatient surgical procedure Dr. Mohr removed bone spurs from the top of the joint and remodeled the joint and was able to restore more motion to it. During the surgery, Dr. Mohr noted clean cartilage and no unusual damage. Mr. O’Neal had several weeks of extensive rehabilitation after his surgery.
Symptoms of Hallux limitus:
Pain around the big toe joint, grinding sensations on top of the joint, build up of bone spur with enlargement of the area around the joint (usually at the top of the joint), Swelling and redness around the joint, difficulty while wearing flexible shoes , sandals flip flops. Pain when wearing narrow shoes and high heels due increase pressure on the joint. Pain in other parts of the body from change of the regular pattern of the walking of the patient.
Diagnosis is usually made by obtaining medical and social history and physical exam, x rays, CT scan or MRI and sometimes blood work to evaluate for other arthritic conditions.
Conservative Treatment may include: oral and injectable anti inflammatory medications, activity modification, shoe modifications (usually stiffer sole shoe or sandals, padding inside the shoe) , over the counter orthotics (Pre fabricated-arch supports placed in the shoes) or custom made orthotics, physical therapy.
Rest, immobilize, ice and compression of the foot may used by the physician. We may place the foot in a wrap or a walking boot. Surgical intervention will be the last resort. There are several surgical procedures that can be utilize assist in restoration of the joint motion and relief the pain.