Hallux Rigidus (or Limitus)

"I have pain with full relevé."

Causes

This condition is characterized by pain and/or restriction of movement at the joints of the big toe. To achieve full demi-pointe the metatarsal phalangeal joint must be able to make a 90 degree angle. Dancers who start later in life may lack this much mobility. A dancer without mobility who forces a high demi-pointe will cause the bones in the joint to impinge on each other. If this is done repeatedly, bone spurs will develop leading to even further decreased motion in the joint, inflammation and eventual degeneration of the joint.

Compensations for lack of full mobility include sickling. This position will decrease impingement but it is not an esthetically acceptable line and puts the dancer at risk for ankle sprains. An acceptable and safe compensation for this condition is a half demi-pointe position. The dancer must learn to rise onto the ball of the foot without forcing the foot into full demi-pointe.

Treatment

During the acute stages, rest and ice are helpful to reduce pain and inflammation. A good way to ice this injury is with an ice massage for 5 minutes. Stretching of the foot can be done to help improve flexibility. The stretch into a demi-pointe position can be done in a non-weight bearing position, in a pain free range and should be held for 30 seconds.

The dancer should assess the available pain free range of the joint and learn to work within that range.

Taping the great toe to restrict full demi-pointe can be effective in relieving symptoms. The tape should be applied so that the toe remains slightly downward (plantarflexed).

Mobilization of the metatarsal phalangeal joint by an experienced Podiatrist is also quite effective.

BOOK an assessment  with our podiatrist  who will provide treatment and identify and correct  any underlying biomechanical issues and muscle imbalances and assist with rehabilitation.