My big toe problem used to just be annoying. Now it is troubling…well, enough so that I looked up my symptoms on Pinterest. Surprisingly, it was easy to self-diagnose the pain in my big toe.
The pain in my big toe joint is called Hallux Limitus. I swear this is really a curse from the Harry Potter series.
So What is Hallux Limitus?
Hallux Limitus is an arthritic condition of the big toe (aka the Hallux, yeah I looked that up). The cartilage in the big toe joint that attaches the big toe to the foot is gone, or mostly gone. The joint bones and the tissue surrounding them become irritated over time from the grinding of the joints.
After a while, a bone spur can develop on top of the joint. The toe also loses flexibility. Sadly, I think this has happened to me.
If you have this, then you know Hallux Limitus can cause problems for a runner.
Just ask Sanya Richards-Ross.
The Olympic champion sprinter suffered from the more advanced version of Hallux Limitus called Hallux Rigidus, where the joint refuses to bend anymore. She had surgery last fall to alleviate the pain.
Knowing someone of her ability has a problem like this makes me feel a ton better in a strange way.
Hallux Limitus and Runners
As a runner with Hallux Limitus or Rigidus, you will unconsciously change your stride in order to avoid pushing off of your big toe. But that’s precisely where a runner should push off. Instead, you turn your foot to push off the smaller toes, which not only results in a less powerful stride, but also causes ankle, heel, knee, hip and lower back problems.
Yay. I have all of those on my left side.
Signs and Symptoms to Watch For
Signs of Hallux Limitus usually come on slowly over time. According to this article, “The pain can be mild and temporary or deep, sharp, and chronic. Typically it is a deep, aching type of pain. In some cases, bunions or bone spurs develop at the joint and cause additional pain. When the big toe is not in use, symptoms tend to diminish.”
Symptoms of Hallux Limitus can include:
- Pain in the big toe joint during weight-bearing movement (ahem, running)
- A grating or grinding feeling in the toe joint
- Development of a bone spur
- Limited flexibility and stiffness of the big toe
- Difficulty wearing high heels or flexible shoes (ahem, flip flops, ahem, minimalist running shoes)
- Tightness around the big toe joint
- Inflammation, swelling and redness of the big toe joint (especially on top — oh, hi, this is me)
- Pain in the ankle, knee, hip or lower back on the same side as the big toe that is bothering you (from changing your gait)
This podiatrist explains all about Hallux Limitus in this video really well.
Hallux Limitus is not to be confused with bunions (which are generally on the side of the big toe) or gout, which is usually a sudden pain that comes on at the base of the big toe. Also, can we get a new word for bunions? One of my least favorite words.
How to Keep Running with Hallux Limitus
I don’t know about you, but a little pain in my big toe isn’t going to keep me from running. But there are ways to minimize the discomfort. Here treatment options so you can keep running and manage your Hallux Limitus without a doctor:
- Ice the swollen area
- Take a couple days off (hahaha!)
- Shoes with a wider toe box and stiffer soles (Hokas? I have Altras, which have a wonderfully wide toe box, but the soles are too minimal for this condition. In related news, anyone want to buy some used Altra Intuitions? Under 20 miles on ‘em.)
- Rocker-soled shoes (oh, hale no)
- Shoe inserts for Hallux Limitus (the Vasyli Howard Dananberg Orthotic is supposed to be good and you can find it on Amazon)
- Vitamin I (Ibuprofin) – I’d save this for really painful, swollen days; don’t kill your kidneys
- Mobility exercises – Go here for Hallux Limitus exercises (these align with what my PT was doing for my toe over a year ago)
After you’ve/I’ve tried these treatment options, if they aren’t working, it’s probably time to see a podiatrist. My advice: Try to find one that’s a runner. They understand us crazies.
Here are some ways a podiatrist can help your Hallux Limitus:
- Cortisone shot, which CAN help for up to a year
- Surgery (shaving off the bone spur that developed from Hallux Limitus or Rigidus, altering the joint, joint replacement, etc.)
I’m going to try to manage mine on my own for a few months, but if it doesn’t get better, I suppose I’ll go ask for a cortisone shot. A few years ago, I had cortisone shots in the bottom of my left foot for neuromas and I haven’t needed one since. Sometimes, the area just needs a little time to heal itself.
Do you have Hallux Limitus or Rigidus? How do you manage it? Shoe suggestions?