Hallux limitus and hallux rigidus are spectrums of deformity of the big toe's first joint. The first joint of the big toe can flex down and extend upwards. Hallux limitus is the reduction in the normal range of motion of the upwards movement of this joint.
· Pain at the first joint of the big toe
· Pain when extending the big toe
· Tenderness at the base of the big toe
· Swelling at the base of the big toe
· Difficulty when walking or weight bearing on the front of the foot.
· Pain and reduced range of motion when lunging.
When you are walking, the final stage of the foot being on the ground is known as toe off. At the toe off stage, the big toe extends stretching out the muscles and tendons in the sole of the foot. This movement facilitates a biomechanical movement called the Windlass mechanism. During extension of the first toe, the ball of the foot pushes downwards and helps to create the arch. In hallux limitus and rigidus this is reduced or nonexistent. Orthotic insoles with some reverse Morton’s extension helps to encourage the windlass mechanism. A Morton’s extension will prevent the Windlass mechanism from occurring and therefore takes the pressure off the first joint of the big toe. Depending on the severity of the reduction of the movement in the big toe a Morton’s extension or reverse Morton's extension will offload the first toe or help preserve its movement.
Custom made insoles with forefoot additions have been shown to be the most beneficial type of orthotic in feet with hallux limitus or hallux rigidus.
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