Got A Stiff Big Toe? It Could Be Stiff Hallux Rigidus

A Stiff Big Toe Is A Big Deal

The big toe joint anatomically known as the 1st metatarsophalangeal joint is the most common site of arthritis in the foot. The big toe joint is crucial when moving seeing as with every step taken the metatarsophalangeal (MTP) joint has to bend and if you develop a stiff big toe then normal walking can become both impacted and uncomfortable. The biomechanics of the big toe joint are such that every time you take a step the 1st MTP joint bends into extension,this allows the foot to roll forward and push off whilst wearing a huge amount of body weight when doing so. Injury or “excessive” use over time can cause changes at the MTP joint, resulting in overall big toe joint changes involving the bone, cartilage and surrounding soft tissues. Such changes can negatively effect the joint, where a painful and stiff big toe can have the subsequent flow on of negatively impacting an individuals overall activity levels and therefore as a result of something as simple as a stiff big toe an individuals general health can suffer. Without a normal functioning big toe it makes things very challenging with regard to balancing, walking, running, rising up on to the balls of the feet and can make even bending over tough.

Hallux rigidus is the medical name for a stiff big toe and can be the result of arthritis in the 1st MTP joint. When movement of the big toe is only more mildly limited (as may occur in the early stage of joint changes) it is referred to as hallux limitus. A stiff big toe usually develops in adults around the ages of 30-60 years old and at least in the early stages conservative measures and treatment taken can frequently make significant improvements in an individuals function and pain levels.

What Causes Hallux Rigidus?

Hallux limitus and ultimately the progressing into hallux rigidus may result from an injury to the toe, repetitive sporting endeavors, employment and/or lifestyle demands over an extended period of time as well as anatomical variations in the foot that may lead to an increase in stress on the joint accumulating over time. Similar to other load bearing joints in the body the ends of the bones in the big toe are covered with a hard wearing articular cartilage that aids in smooth joint movement. As mentioned above, gradual wear of time due to repetitive loading or resulting from acute injury the articular cartilage of the big toe joint can “break down”  and osteoarthritis develops. Osteoarthritis of the big toe may result in the individual experiencing pain in their toe and as part of this degenerative process the articular cartilage changes and the development of bone spurs the joint space narrows and some of the associated soft tissues “tighten” reducing motion at the joint causing a stiff big toe.

Certain sports, injuries and medical conditions have been implicated in causing a stiff big toe, some of these include:

• Ballet, ballet is a sport that requires repetitive use of positions such as demi-pointe which forces the first MTP joint to flex at a 90° angle. This posture may ultimately increase the risk of developing hallux limitus.
• “Turf toe” is an injury to the first MTP joint and is caused by the sudden bending back of the big toe an injury more common in sports like American football but occurs also in other football codes.
• A Stubbed toe, “banging” the big toe against something hard and “stubbing” the toe can have a greater impact than just bruising or cutting the tip of the big toe. The impact force can cause the MTP joint surfaces to “bash” against each other causing acute joint changes.
• A fractured toe again similar to a “stubbed toe” can potentially cause changes to the joint particularity if the fracture is intra-articular.
• Inflammatory conditions such as rheumatoid arthritis will sometimes target the big toe joint.
• A metabolic disorder such as gout is another condition that is renowned for targeting the big toe joint and can cause destruction to the articular cartilage with repeat episodes ultimately leading to hallux limitus and/or hallux rigidus.

Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Got A Stiff Big Toe? It Could Be Stiff Hallux Rigidus should consult his or her general practitioner, physiotherapist, medical specialist, or otherwise appropriately skilled practitioner.