Hallux Rigidus – Effective aid forarthritis of the metatarsophalangeal joint of the big toe

A photograph of a pair of feet affected by hallux rigidus.

© jakkrit pimpru | shutterstock.com

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Does pain shoot through your foot with every rolling movement so that every step becomes torture? Is the pain particularly severe in your big toe? Then this could be hallux rigidus, a painful disorder of the toe accompanied by arthritis and stiffening of the toe joint.

But don’t worry; even if the first signs of wear and tear on the area affected by arthritis are already noticeable, you can do something. There are still ways to prevent further stiffening and if you read on, we explain the possibilities and what you can do to improve your condition.

Jump directly to the topics and chapters that are most relevant to you!

Roland Liebscher-Bracht

Roland Liebscher-Bracht

Germany's most trusted pain specialist and author of several bestselling self-help books on the treatment of pain conditions.

 
Read more

Roland Liebscher-Bracht is Germany's most trusted pain specialist and author of several bestselling books on pain treatment. Together with his wife, Dr. med. Petra Bracht, he has developed a revolutionary method to treat pain conditions. With the help of the so-called "osteopressure", where you press specific points on your body, and special stretching exercises, pain can be stopped entirely without medication or surgical intervention. This pain treatment allows you to alleviate pain by yourself. Find out how exactly this works in this article or our numerous YouTube videos.

Roland Liebscher-Bracht

Germany's best-known pain specialist and author of several bestselling books on self-help against pain.

 
Read more

Roland Liebscher-Bracht is Germany's best-known pain specialist and author of several bestselling books on pain treatment. Together with his wife, the physician Dr. Petra Bracht, he has developed a revolutionary new form of pain treatment: With the so-called "Osteopressur", in which certain points on your body are pressed, and special stretching exercises, pain can be stopped completely without medication or surgical intervention. It is particularly important that this pain treatment gives you the opportunity to help yourself against your pain in a self-determined way. You can find out exactly how this works in this article and in the numerous YouTube videos.

1. Hallux Rigidus at a Glance


Hallux rigidus literally means stiff big toe (Hallux = big toe, rigidus = stiff or heavy). It describes arthrosis in the metatarsophalangeal joint. It is very common and is sometimes referred to as “metatarsophalangeal joint arthrosis” because of the limited mobility of the toe.

An illustration of the pain occuring with a hallux rigidus.

© Aleksei Martynov | shutterstock.com

Metatarsophalangeal joint arthrosis is divided into three stages. Find out which stage of the disease you are currently in:

  • Early stage: A painful restriction of movement in the toe, most noticeable during the rolling motion of walking. Sufferers automatically try to reduce the load on the toe while walking. Heeled shoes become painful to wear. If the arthrosis is not very advanced, you can improve your condition by doing our exercises.
  • Middle stage: With increased pain, restriction of movement also increases. Every rolling movement becomes torturous and causes a painful forefoot. The first degenerative changes become visible during examinations. 1)
  • Late stage: Arthrosis has fully developed and consolidated. The metatarsophalangeal joint of the toe is almost completely immobile – the stiffening makes walking extremely difficultt. Calluses start to form on the sole. The full extent of the arthrosis is clearly visible on X-rays. 2)

If you have reached the third stage, you may already have a diagnosis, but you don’t have to suffer. We recommend manual osteopressure therapy with one of our pain specialists before beginning our exercises. Many of our patients have achieved a rapid and massive improvement in their conditions.

The Best Exercises and Tips Against Hallux Rigidus

We've got your back! Download our FREE PDF guide featuring our 6 most effective exercises for getting rid of Hallux Rigidus. 
All gain. No pain.

THE BEST EXERCISES AND TIPS AGAINST Hallux Rigidus

We've got your back! Download our FREE PDF guide featuring our 6 most effective exercises for getting rid of Hallux Rigidus. All gain. No pain.

THE BEST EXERCISES AND TIPS AGAINST Hallux Rigidus

We've got your back! Download our FREE PDF guide featuring our 6 most effective exercises for getting rid of Hallux Rigidus. All Gain. No Pain.

2. Symptoms, Causes, and Diagnosis of Hallux Rigidus


It is important that you understand exactly how and why the hallux rigidus has formed so you can contribute to improving your foot health.

2.1 Symptoms of Hallux Rigidus

It usually takes several years for the toe to completely stiffen, so there is time to take countermeasures.

The first signs of arthrosis in the foot:

  • Pain in the metatarsophalangeal joint of the toe – usually temporary under stress,
  • Painful sensations, especially when rolling onto the metatarsal bones that connect the ankle to your toes,
  • Stabbing sensation when walking,
  • Swelling of the big toe,
  • Inflammation – a painfully swollen and reddened metatarsophalangeal joint in inflammatory activated arthrosis,
  • Increasing difficulty in finding suitable shoes,
  • Change of gait – walking on the outer edge of the foot,
  • Twitching muscles in the affected foot,
  • Callus formation, especially on the sole of the foot,
  • Painful water retention (edema) in the bones below the joint surface,
  • Rubbing noises during movement,
  • Formation of osteophytes (bone spurs) on the edges of the joints and pain when moving,
  • Complaints in the knee and hip joints due to incorrect weight-bearing.
A picture of a foot.

All of these issues occur to varying degrees, depending on the stage that patients are in. Acting early can relieve the signs of arthrosis and significantly slow down or even halt the course of the disease. Find out more about the appropriate treatments in the next chapter.

2.2 Causes of Hallux Rigidus

Hallux rigidus is arthritis in the metatarsophalangeal joint of the big toe. General causes of arthritis and risk factors that promote the formation of osteoarthritis in the toe include movement that is too one-sided.

Many of us often move in an unbalanced way and feet suffer from lack of movement. Rigid, sturdy shoes and a lack of barefoot walking exacerbate the problem.

Important: Your brain stores frequently used movement patterns and, by controlling your muscles, ensures that they can be implemented quickly and precisely in everyday life – you don’t have to think about walking and can just start running. The muscles and the surrounding fascia (i.e. the connective tissue) adapt exactly to these movement patterns. If your legs and feet are not challenged by regular exercise, their muscular-fascial balance changes, leading to painful sensations.

The pull on the metatarsophalangeal joint becomes so strong that it presses the bones together. The joint space melts and cartilage wears out disproportionately, causing bone to rub against bone. In the long run, degeneration is pre-programmed here and the joint becomes completely stiff.

You can prevent wear and tear going this far with our exercises and therapy. By reducing the excessive pull of the muscles and fasciae, can enjoy improved foot health.

Risk Factors for the Formation of Hallux Rigidus

Extrinsic factors:

  • Inflammatory joint diseases such as polyarthritis or gout.
  • Activities that cause increased stress on the metatarsophalangeal joint, such as ballet dancing or sports like basketball.
  • Unsuitable footwear can intensify hallux rigidus and general foot health i.e. high heels, thin soles, or a very tight toe area.

Intrinsic factors:

  • Foot shape: In some cases, the foot is changed from birth, so a hallux valgus or hallux rigidus can develop more easily.
  • Other pre-existing conditions: Splayfoot or other foot malposition promotes unbalance of the muscles and fasciae in the entire foot and makes them liable to a hallux rigidus.
  • Metabolic disorders: Rheumatoid arthritis, gout, and diabetes can also weaken fascias.
  • Osteochondrosis dissecans (bone cartilage damage) of the toe joint.
  • Extra-long 1st metatarsophalangeal bone: This is one of the bones that form your toe and is located in the middle of the foot.
  • Malformed 1st toe ray (metatarsus elevatus): The bones that connect your toes to your ankle can diverge, causing malpositioning.

How Hallux Rigidus Is Diagnosed:

A medical doctor focuses on the typical signs of arthritis, such as joint space narrowing, joint wear, pebble cysts, changes in the bone, or joint destruction. X-rays are usually taken.

The Best Exercises and Tips Against Hallux Rigidus

We've got your back! Download our FREE PDF guide featuring our 6 most effective exercises for getting rid of Hallux Rigidus. 
All gain. No pain.

THE BEST EXERCISES AND TIPS AGAINST Hallux Rigidus

We've got your back! Download our FREE PDF guide featuring our 6 most effective exercises for getting rid of Hallux Rigidus. All gain. No pain.

THE BEST EXERCISES AND TIPS AGAINST Hallux Rigidus

We've got your back! Download our FREE PDF guide featuring our 6 most effective exercises for getting rid of Hallux Rigidus. All Gain. No Pain.

3. Treatment of Hallux Rigidus


Our therapy and treatment can achieve quick positive results for sufferers of hallux rigidus.

3.1 Hallux Rigidus Treatment with Liebscher & Bracht Pain Therapy

Our aim is your freedom from pain – and to stop the wear and tear from continuing. With an early start, malpositioning, shortening, and damage to the metatarsophalangeal joint is more likely to be corrected without medical intervention. In fact, many patients don’t need surgery or painkillers to alleviate their painful conditions.

A man hold a leg of an anatomical human skeleton in his left hand, pointing with one finger at some trigger points on skeleton's foot.

In our experience, permanent incorrect loading of the feet and one-sided use causes the painful condition. Repeated one-sided use causes the muscles and fasciae of the feet to develop over-tensions. These affect the metatarsophalangeal joint; the traction on the joint becomes stronger and the bones contract. Cartilage is broken down until, finally, bone rubs against bone. At this point, the joint space is almost non-existent. The increased tensile stress is what causes the pain.

Our treatments aim to relieve the pressure on the metatarsophalangeal joint and to stretch and relax the surrounding muscles and fascia as much as possible.

Osteopressure Tool

Osteopressure as an Acute Measure and First Step in Case of Severe Complaints:

Our special manual therapy can assist with pain conditions and difficulty walking. Osteopressure releases cramps and relaxes the muscles and fasciae, without the side effects of medical intervention and painkillers. Receptors in the periosteum are located at very specific points on your feet and legs; these are pressed during osteopressurization. The excessive tension in the muscles and fasciae of the feet can normalize and the pain can be switched off. In the case of acute and severe pain, contact one of our trained pain specialists. They will apply osteopressure and give you tips for further courses of treatment that can ameliorate arthritis and associated conditions.

You can also apply osteopressure yourself. With our specially developed massage set, you can press the special osteopressor points on your foot. Our exercise guide gives detailed explanations of which points you have to press and how.

Fascia Roll Massage Balls

Stretching Exercises and Foam Rolling Massages for Long-Term Success:

After osteopressure, you can help to reduce the tension and pressure on the metatarsophalangeal joint of your toe. Changing movement patterns prevents the pain from returning. Our pain specialist Roland Liebscher-Bracht has developed special muscle-fascia stretching exercises to help you effectively regain your natural movement potential. Our foam rollers help you to relax your muscles and fasciae. The foam roller massage removes waste products from your body faster, your muscles regenerate faster and the fasciae can become suppler again.

Barefoot feet on pebbles.

Tip: Walk barefoot! By walking barefoot you train and strengthen the foot muscles and provide more stability. Sideways, backward and forwards, picking things up from the ground with your toes – any variation is very welcome to the muscles in your feet.

3.2 Conventional Treatment of Hallux Rigidus

Conventional medicine aims to slow down metatarsophalangeal joint arthrosis of the toe to enable pain-free walking for as long as possible. Methods include:

  • Special insoles,
  • Traction treatment as part of physiotherapy,
  • Prescription physiotherapy,
  • Anti-inflammatory painkillers,
  • Physical therapy,
  • Cartilage-protecting injections,
  • Cortisone injections,
  • If these measures are exhausted, surgery is considered.

3.3 Is Surgery Necessary for Hallux Rigidus? No!

We believe that surgery is not necessary at all and that you can achieve good results with our exercises.

The Best Exercises and Tips Against Hallux Rigidus

We've got your back! Download our FREE PDF guide featuring our 6 most effective exercises for getting rid of Hallux Rigidus. 
All gain. No pain.

THE BEST EXERCISES AND TIPS AGAINST Hallux Rigidus

We've got your back! Download our FREE PDF guide featuring our 6 most effective exercises for getting rid of Hallux Rigidus. All gain. No pain.

THE BEST EXERCISES AND TIPS AGAINST Hallux Rigidus

We've got your back! Download our FREE PDF guide featuring our 6 most effective exercises for getting rid of Hallux Rigidus. All Gain. No Pain.

4. The Best Exercises for Hallux Rigidus


Give your feet more variety! One-sided strain causes excessive tension on the metatarsophalangeal joint of your toe, wears out the joint cartilage, and arthrosis becomes more likely. With targeted exercises developed by our pain specialist Roland Liebscher-Bracht, you can counteract the excessive tension yourself. With regular training, your hallux rigidus can improve and your discomfort and pain can disappear. If you are new to our exercises, read our checklist before you start.

A woman is kneeling and stretches her toes with her hands.
Stretch Detail

Stretch the ankle and bend the big toe: 

  • For this exercise, go down on all fours and bring your buttocks as far back as possible to your feet.
  • Grab your big toe and pull it carefully into the bend.
  • You will feel a slight pressure pain in the back of your foot, the ankle, and the toe.
  • Stay in the extension for about two minutes and try to get the toe further into the stretch.
A woman is stretching her toes while facing the wall, her hands are placed on it.
Close-up of a toe stretch using a foam roller.

Stretch the calf and overstretch the big toe:

  • Stand in front of a wall and spread your feet hip-wide. The tips of your toes pointing straight towards the wall.
  • Lunge and place the big toe of the back leg onto our Mini-roll.
  • The muscles around your hallux rigidus are stretched perfectly and the calf stretch removes tension from your calves and the sole of your foot.
  • Change sides after about two minutes.
A woman is foam rolling her foot.

Foam rolling massage on the sole of the foot:

  • Grab our mini massage ball and roll the entire sole of your foot in strong, spiral movements.
  • At points where you feel painful tension, roll intensively.
  • Loosening the fasciae in the sole of your foot reduces the tension on the metatarsophalangeal joint.
  • You can even do this exercise while watching TV so try it out now!

Liebscher & Bracht's Five Pillars of Practice


Roland Liebscher-Bracht is performing a pain-free exercise.

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