Hallux rigidus is a painful condition of the first metatarsophalangeal joint, or what many people consider the ball of the foot. It is a degenerative condition in which bone spurs develop at this joint and the joint space narrows. It can occur after a traumatic event to the great toe, or it can result from wear and tear over time.

Signs and symptoms of hallux rigidus

The athlete with hallux rigidus usually complains of pain at this joint. He or she will often complain of stiffness and decreased motion with certain activities. Usually extension of this joint is limited, which bothers an athlete with the ability to push off. A sports medicine physician or foot and ankle surgeon often notices swelling and pain at this joint. Loss of motion, especially extension, of this joint is noticeable. X-rays will demonstrate degenerative changes, with bone spurs evident.

Treatment options for this cause of foot pain

Treatment is initially nonsurgical. Anti-inflammatory medications, shoes with wider toe boxes, and shoe inserts or orthotics to pad the great toe at this joint can be helpful. Sometimes the physician will inject cortisone into the joint to temporarily relieve symptoms. If symptoms are not improving, surgery can be attempted. Some of the surgical options include simply removing bone spurs, cutting the metatarsal to change the angle of the joint and allow more motion with activity, and even fusing the joint. Surgical treatment is often a last resort, as it is often a long process to return to sports after surgery.

Location of pain with hallux rigidus
The athlete with hallux rigidus often has pain at the first metatarsophalangeal joint (white arrow), especially with extension of the joint.

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