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Physical Therapy for Hallux Rigidus

Apr 17, 2011 | By M. Gideon Hoyle

Hallux rigidus is a disorder in the joint at the base of your big toe that causes pain and increasing movement limitations. Inability to properly use your big toe can lead to difficulties when you try to walk, stand, climb or stoop down. You can help relieve the effects of hallux rigidus with physical therapy and movement modifications.

Hallux Rigidus

Potential causes of hallux rigidus include the way you plant your foot on the ground when you walk, structural problems in your foot or ankle, direct injuries to your big toe, genetic predisposition and rheumatoid arthritis. In many cases, the condition occurs for no known reason. In its early stages, when range of motion in your toe is only partially limited, the condition is also known as hallux limitus. Technically, hallux rigidus only occurs when you completely lose your range of motion and your toe completely stiffens.

Physical Therapy Basics

The main goals of physical therapy for hallux rigidus are pain reduction and improvement of your big toe's range of motion, according to MD Guidelines. To help relieve your pain, your physical therapist may recommend ultrasound treatments, which use sound waves to heat the tissues in your big toe joint. He may also recommend electrical stimulation treatments, which reduce swelling with the help of pulsed, high frequency electrical current. To help improve your range of motion, your physical therapist can gently manipulate your big toe joint. He can also teach you non-weightbearing ways to stretch your foot.

Additional Steps

To improve the range of motion in your affected joint, your physical therapist may recommend that you wear a device called a spacer between your big toe and second toe. Your doctor or therapist may also recommend that you wear shoes with a large toe box, or shoes that have rocker-bottoms or stiff soles. In addition, your doctor or therapist may ask you to modify or avoid activities that can irritate hallux rigidus, including activities that require you to squat, rise up on your toes or lunge forward.

Considerations

Many people who undergo physical therapy for hallux rigidus are able to stop or significantly slow the progression of their symptoms. However, in some cases, physical therapy and other treatments fail to stop hallux rigidus. In these circumstances, surgery is likely the only way to regain or maintain function in your big toe. Surgical options include partial removal of the upper or lower end of your big toe joint and joint replacement. Consult your doctor and physical therapist for additional information on limiting the effects of hallux rigidus.

References

Article reviewed by Veronique Von Tufts Last updated on: Apr 17, 2011

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