Hallux Rigidus: Effective aid for arthritis of the metatarsophalangeal joint of the big toe

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.

• 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.

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.

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.

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.

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.

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.

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.

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.