Hallux Rigidus - Big toe joint pain
 

I've been training pretty hard and playing a lot of tennis lately and the soreness in my big toe joint, where the base of the toe meets the foot is getting increasingly more painful. I just looked around online and it's called Hallux Rigidus. I'm going to have to look at different shoes with a larger toebox, but has anyone ever successfully dealt with this or have any suggestions on how to manage it?

I had a very similar problem in my right foot earlier this year / late last year. I was playing 10 to 15 hours a week to prepare for our league. The only thing that helped was cutting back a little and giving my foot a day or two of rest between court sessions.

I actually had surgery in Jan this year. My stemmed from an old injury. The doc went in and drilled out that joint due to bad/damaged cartilage and also had to shave down a bone spur on the foot bone. less aggressive treatments before that were basic elevation, ice, Alieve, etc.
Have you seen a foot doc?

I had surgery a couple of years ago for this. It helped a lot. However, with surgery there will be a few weeks (even a couple months) before you can go back to playing tennis. You should definitely see a podiatrist.

Remember that the shoes you play in are generally less crucial than what you wear the rest of the week, which is why women are far more likely than men to have hallux rigidus and hallux valgus. This was also shown to be the case with plantar fascitis, with hard-sole daytime shoes being a much larger risk factor than anything worn during athletic activity.

I have not seen a podiatrist yet, but I will if it persists. I'm pretty certain it's not my everyday shoes that are the issue. Until now I have only noticed the pain during tennis.

I have noticed that my service motion is part of the cause. I use basically the same service motion as Federer, so when I start the motion by rocking to the forward foot and extending the back foot, it puts side pressure on the toe of the back foot, and then when I push off the back foot it kind of rolls over the side of the toe again. I have tried to adjust this, but so far I haven't found good way to do it.

I had a similar condition a few years ago. (Hallux Limitus - the joint was not totally rigid. It still had a limited degree of flexibility.) It really didn't bother me too much in my everyday life, but it made running and playing tennis a living hell. I did some research about the condition and learned that it wouldn't get better on it's own. In fact, if left untreated it will slowly (and painfully) increase the injury to the joint. I went to a podiatrist who x-rayed the joint, and even to my untrained eye, it was obvious that cortisone shots, ice treatments, heat treatments, etc., were not going to do the job. So, a few weeks later, I had the surgery. I was home by lunch, walking in tennis shoes in one week, wearing dress shoes in three weeks (although this was VERY uncomfortable) and playing tennis in three months. There was a bit of swelling for about a year and the occasional twinge of discomfort for the same period of time. Now, three years later, everything is OK. The range of motion in the joint is not quite the same as my normal foot, which has caused me to lose about half a step in quickness on the court. Once in a blue moon I might have a twinge of pain if I land on it hard or push off on it hard, but nothing I can't very easily live with. Anyway...my result was positive. That said, I've heard some foot surgery horror stories. Make sure your doc knows what he's doing. Although I didn't do this (didn't think about it until after my surgery), if you live near a major university or a pro sports team, call them and ask who they use for this type of injury. If I recall correctly, I think Shaq had this some injury, had the surgery, and was playing again in a matter of weeks.

Good luck.

Last year I was diagnosed with hallux rigidus, arthritus, a bone spur and sesamoiditus all in my right big toe and the ball of that foot. I read a lot of forums where people advised avoiding surgery if at all possible and for as long as possible, so even though my doctor wanted me to go under the knife right away, I said no. All I did was buy some Dr Scholl's cushioned arch supports and alternate between walking around barefoot and using those supports in my shoes for the last year. 12 months ago I was in a lot of pain just sitting on the couch with my foot elevated, and I was icing it constantly throughout the day and taking OTC pain medication; now I'm back to running (including HIIT) 4 or 5 days a week with very minimal discomfort every so often, and I never even have to ice or take anything.

Please, please don't rush into any surgery. Start by resting the area more than you want to, and find a pair of shoes and/or inserts that ease your discomfort while walking around.

Big Toe Pain
 

Wider shoes and at least 1/2 longer size really helped me. I also have this problem. You may also consider Mortons Toe?
Please see link below.
http://mortonsfoot.com/whyuhurt.html
The Prokenetics have been a great help to me...
I am not trying to sell this product so, "no piling on."
I would be interested read what Charlie Federer or Posture Guy thoughts are on this type of product. I hope this helps. I am told it is all about "foot strike."

I seem to be getting a lot of success with a little simple physical therapy. Putting a light weight into a sock and knotting the end, then placing it between the first two toes, with the heel on the ground, and raising the weight up with the toes. I'm pain free for the first time in months.

If you all don't mind me asking, what are your ages?

I'm 50, and have been dealing with this condition for a year or so in my left (serving) big toe. When I went to my sports injury doc, he had me put these metatarsal support pads in all of my shoes because he said my traverse arch was breaking down. That seemed to help for a while, but lately, the toe has been bugging me again.

So I'm wondering, at 50, what my reasonable expectations for recovery might be. I'm also wondering if any of the mobility self-therapies (you can find them all over YouTube) have been of value to any of you.

As always, any information from those of you who have gone through this is greatly appreciated.

Damp

I'm 52 and I've had success with the PT I mentioned in my earlier post, but you have to keep at it or it comes back.

Just curious NE1, where did you learn this therapy technique? Online? A physical therapist? Somewhere else?

I ask, because in my research so far, I haven't come across anything similar.

And by "light" weight, what are you suggesting? A pound? Less? More?

One of my friends, not a tennis player, had a bunion and had to have surgery.

http://en.wikipedia.org/wiki/Bunion

A tennis friend of mine, who is in his 30s, had a small broken bone in the area where the big toe connects to the foot. There was no acute injury and it probably developed over time. This injury location is common especially to those who stress the foot such as ballet dancers. He is very fast around the court. He played on it in pain for a year or so. He is getting surgery next month and also has a torn tendon in that area.

I'm not sure if I found it on the web or someone told me about it. I probably use about a pound. Start with whatever is comfortable. You can also use a rubber band and hold the other end with your hand.

This Yoga exercise is also surprisingly effective and the pain relief is often immediate. It takes a while to get the knack of it, but try to get the web of the hand all the way into the web of the foot. http://www.youtube.com/watch?v=xnnqIa7ife0

Thanks, NE1. I'll give 'em both a try.

Damp

Hoo doggies, I'm researching the topic, and there is an overwhelming volume of information on the condition.

Causes: Gout, arthritis, trauma.

Severity: Limitus, Rigidus (several stages), End Stage

Treatments: Stiff-Toed Shoes, Rocker Shoes, Orthotics (an infinite array), Mobility Therapies (a long list), Surgeries (several).

It's a lot to digest and process. And it can't all be true. The only common theme is that the condition is progressive. Terrific.

I have an appointment with my sports injury doc in a week. Until then, I guess I'll continue to fret over my long-term prospects of playing this sport we all love.

NE1,

I took your advice, and I've started doing this. Did you find that it merely eliminated your pain? Or did it also restore some of your joint mobility?

Damp

They go hand in hand, so both. Let us know if it helps.

You might also want to take a look at your footwork and see if there's anything you are doing that might exacerbate the problem. In my case, I found that during part of my preparation for the serve I had a habit of putting weight on the side of the big toe.

How curious.

It is my serving toe (left foot). Which side of your big toe did you weight up? The inside or outside? And how on Earth did you figure that out?