"Severe" Hallux Rigidus... What now?

Hi, I'm in my 30's and end up limping from what has been diagnosed as Hallux Limitus by 3 Podiatrists who said I was too young for cheilation, but I don't even run basic errands after work anymore, let alone run for sport. I would be happy to get through a work day without limping. It caused serious back problems which physical therapy has helped for now. The weird thing is that the major pain is under the 2nd toe in the ball of the foot, but it is severe. The joint itself doesn't hurt too much.

Any thoughts on the metatarsalgia beneath the 2nd toe. My only guess is that the bone growth is pushing at nerves.

I have a hammertoe in the 4th toe and the Morton's neuroma. Could surgery for this help in the meantime?

What course of treatment did you pursue? How did it work?

OP,

I was a low 15 minute 5k dude. I had a pretty nasty case of hallux rigidus about eight years ago. It affected the major joint (forget what it's called) in both big toes. Joint movement was limited, I couldn't run comfortably, and I had bone spurs.

If you have bone spurs, there's not really any other "fix" than surgery. I had the surgery (chilectomy, I think it was called? Basically, they went in there and cleaned the joint out. I'm sure I'm not describing this with perfect accuracy).

I'll say that I'm pleased with how it all went. Recovery time isn't quick. It took me the better part of a year before my feet started to feel anything like normal. But, for me, it was worth it.

As for running. I could do it now, if I wanted, and I'm pretty confident I could run at a high level, with an adjusted training load and plenty of rest and ice. Also, make sure your footwear is appropriate and fits well. The weirdest thing about all of this for me has been that I have to wear bigger shoes. Like, up to a full size bigger. Or, by the end of the day, I can barely walk.

I choose not to run much anymore. For me, preserving my body is more important than trying to break 15 in the 5k.

Also remember that your feet will never be exactly the same after the surgery. The surgery worked well for me, but it doesn't return your body to the state it was in when everything was fine.

Wow, Wilford... your post sounds very much like my experience. My chielectomy was 2+ years ago, just before my 40th b-day. I thought I'd be back to running pretty soon. The surgeon thought I'd be able to run Boston in April after a December operation. Ha. I ended up needing a 2nd one, 2 months later, to clean out additional spurring, and I wasn't running in relative comfort until the fall - about 7-8 months later after both surgeries.

Now, I run when the rest of my body can handle it. The toe is occassionally bothersome, but that experience basically took me away from being competitive to running to stay fit - I've maxed at 50+ mpw a few times since then. At this age, I guess I'm fine with that.

The part I can't relate to though is the change in shoe size. Nothing has changed for me there. I had a much harder time being comfortable in shoes before the procedures, due to swelling in the joint.

I have been diagnosed with Hallux Rigidus 3 or 4. I'm 54 years old and I only run a 40 min. 10K.

In my case the problem is much more acute on one foot.

I've tried orthotics, because I'm terrified that surgery will spell the end of running.

I found that I've had to work very closely with my podiatrist to develop an orthotic that mostly (not completely - 95%) alleviates my symptoms. I found the following helped a lot:

1. A Morton Extension.

2. Building up the arch support with a pad just behind the first metatarsal head, so the foot "pre-loads" on the pad. I find this prevents the swollen metatarsal head from hitting the ground with a lot of force.

3. I also had the podiatrist add a little thin pad between the first and second metatarsal head, to prevent the head from rubbing against the adjacent bone.

4. Since my problem was on one foot, I had a little padding placed behind the first metatarsal on the opposing foot, to prevent my gate from being lopsided.

5. I also added a soft insole below the orthotic, to give my foot extra cushioning.

All this crap cost me a minute on my 10K time, but I'm just glad to be running.

I find Hallux Rigidus produces a vicious cycle, where the metatarsal head swells like a mushroom, causing the bone to bang on the ground and rub against the adjacent head. By preventing these things from happening, I think we've stopped or perhaps slowed the progress of the disease.

For now, I'm running and walking with virtually no pain and I am sensing the swelling is beginning to diminish somewhat (BTW - walking was more difficult for me than running).

I hope this helps. I wish I had encountered this group sooner!

Hallux rigidus is nothing more than osteoarthritis of the big toe joint. You have to be very foolish to try to continue running with OA anywhere. BTW, the technology to "cure" the biologically resurface an arthritic joint with tissue-engineered cartilage now exists, but thanks to FDA regulations, you can look forward to waiting probably at least a few decades before it will legally be available for use in the great toe joint.

This seems as close to a hallux rigidus general thread as any, so bumping: on-and-off pain associated with activity, particularly walking up hills, floating between the outer metatarsals and the 1st MTP joint. Decent ROM. Might be sesamoids, might be some kind of compensation for 1st MTP problems, might be generic metatarsalgia.

Altra Olympus have helped a lot. Also noticed pretty dramatic improvement with Great Lakes collagen hydrolysate--I tried it once before for a different injury and didn't notice anything then, but two tablespoons produced a pretty dramatic reduction in pain this time around. It's not all the way better yet, walking fast up hills still pisses it off, very very worried I'll have to give up fun outdoor work and the running associated with it and get a desk job. But the shoes and the gelatin might be worth a try if you're having problems.

Have purchased two pair of orthofeet for myself, and they do help tremendously with my PF(plantar Fasciitis). My wife was complaining about her PF, so I suggested getting her a pair of plantar Fasciitis. She didn't want to spend $130 on a pair of orthofeet shoes, but I did it anyway. Now she wears them every day in the garden! Holding up pretty well for the abuse they get too! She won't admit it, but I think she really likes the Quantum's and they do help with the PF.