The great toe joint is an important joint for normal biomechanics and walking or running. When we're moving and the foot is flat on the ground, that big toe or hallux joint is required to bend while the heel comes off the surface. If that joint in the foot does not flex then to be able to walk and run is going to be a lot more difficult. More energy is needed so walking or running becomes very exhausting. When the motion which is not able to take place with the big toe or hallux joint still has got to take place, other joints might be forced to move a lot more at a time that they are not supposed to be moving. This excessive movement could become painful.
There are a number of things that may go wrong with that big toe or hallux joint and interfere with this normal motion. One of the most common ones is a problem that often gets identified as hallux rigidus and as this name indicates, the hallux joint is rigid and will not move. The most common reason behind this is osteoarthritis of that hallux joint. This could be fairly painful and the inflexible joint makes running or walking quite difficult. The most frequent treatments for hallux rigidus are medications to decrease your pain, rocker sole shoes allowing some movement to take place and surgery around the joint.
A less painful type of hallux rigidus is a problem known as hallux limitus where the great toe joint is not stiff but has a decreased range of flexion. As a full range of movement is required at the great toe or hallux joint for normal gait, this limited movement continues to be a problem. The most common cause of this problem is also osteoarthritis. Typically the management of hallux limitus is pain relief with drugs, from time to time strapping is used to limit movement even more so that it is not too painful. Foot supports are now and again used to encourage a more normal movement with the big toe joint. In the most painful situations surgery may well be an option in which a joint replacements might be carried out or the hallux joint is surgically fused to stop it moving.
Another very frequent condition is what is called a functional hallux limitus. This is known as functional as during a non-weightbearing evaluation the hallux joint has got a normal range of motion, however when functioning with the feet on the floor it just doesn't have the full range of flexion. The reason behind a functional hallux limitus is simply not known and the reasons why that big toe or hallux joint doesn't work during weightbearing is not clear. This simply appears to occurs in some people. Numerous hypotheses have already been advanced, most of which appear probable however, there is hardly any direct evidence for one above the other.
There are a variety of treatments for a functional hallux limitus that are aimed at restoring normal biomechanics to the great toe joint. Podiatric doctors commonly use foot orthoses with different modifications for instance a first metatarsal cut out, a Kinetic Wedge or possibly a Cluffy Wedge. All of these designs attempt to increase the motion at the big toe joint to make the joint move more effectively and prevent the functional hallux limitus from occurring.