What is functional hallux limitus?

Pain in the big toe (hallux) could be hallux limitus. This is when the big toe doesn’t move freely without pain or has some restrictions, either by a bone spur or soft tissue impingement at the first metatarsophalangeal joint.

A functional hallux limitus is one condition that is not so obvious to the untrained eye. On xray, the joint space may look totally normal but on a functional level, it may hurt to walk normally or there is a restriction within the joint or up higher in the kinetic chain like at the ankle, knees or hips.

In normal gait patterns, the big toe is fully functional when you can roll off of it to move forward in walking without pain. When pain starts to develop but is left ignored, your body will compensate to move your forward and your gait will be altered. You may develop pain in the ankle since it’s working harder for that loss in the big toe or your other foot will pick up the slack and suddenly it feels like you hurt all over.

Functional hallux limitus is soft tissue dilemma that can be addressed with a rocker bottom shoe and custom orthotic. Exercises and therapies that focus on improving soft tissue mobility is helpful as well.

Depending on the clinical findings and if there are other biomechanical misalignments, a custom orthotic can help to reduce pain. A functional hallux limitus can become arthritic and at that point, injections and surgery may be needed.

Overall, a functional hallux limitus is a sneaky problem that can be supported conservatively with early intervention. In the late stages, surgery can be considered and there is a minimally invasive option for this. Request a consultation to learn more.