Hallux Rigidus Physical Therapy

November 12, 2012

Hallux Rigidus Physical Therapy

Hallux rigidus is the loss of motion of the big toe joint due to structural deformity of the bones. The normal 55 to 65 degree motion of the big toe is reduced to a 25 or 30 degrees range.

Considerations

Apart from the limited motion, hallux rigidus is also associated with pain during heavy activity and rest. The joint is enlarged on the top. You may also notice swelling and redness around it. The symptoms are similar to those seen during gout and arthritis. Inability to use the big toe can make everyday activities like walking, standing, climbing, and stooping down uncomfortable. The condition is usually congenital. However, it may also develop at a later age if your foot pronates excessively. Trauma or other surgery of your foot may predispose you to hallux rigidus. Other causes include genetics and rheumatoid arthritis. The early stage of the disease is known as hallux limitus, and is characterized by limited loss of toe joint motion. This will progress into hallux rigidus when your joint stiffens completely.

Physical Therapy

Physical therapy is commonly used to treat the condition. The main goal of the procedure is to reduce pain and improve the range of motion of the toe joint. Your therapist may prescribe ultrasound treatments to relieve the pain. Electrical stimulation treatments send pulsed, high-frequency electrical current to reduce swelling. The therapist will also teach simple techniques to stretch your foot, without aggravating the pain or the injury.

Some of you may have to wear a device called a spacer between your big toe and second toe. You may also have to switch to shoes with a large toe box, or shoes that have rocker-bottoms or stiff soles. You may also have to avoid activities such as squatting, rising up on your toes or lunging forward.

Options

Most people who undergo physical therapy for hallux rigidus see improvement in the range of the big toe motion. It may also slow the progression of the disease significantly. However, surgery may be required to regain or maintain function in your big toe if physical therapy fails. Surgical options include partial removal of the upper or lower end of your big toe joint and joint replacement. However, surgery is associated with greater recovery time and may not be for everyone. It is best to consult your doctor and physical therapist to learn more about hallux rigidus, and to choose treatment options that are right for you.

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