Is your BIG toe the problem?

We give our core a lot of attention, and rightfully so. It stabilises our spine, which in turn stabilises our entire torso, and to a large extent our entire body. But if we look at our bodies from a different perspective every part of the body essentially has a core—joints, muscles and tendons that build a stable foundation for particular areas.

For the foot? That “core” is the big toe. 

The big toe is responsible for approximately 80-85 percent of the stability in your foot. Your lesser toes curl and lift off the ground, but the big toe’s job is to ground down and build a ‘tripod’ between the end of the toe, the inside ball of the foot and the outside ball of the foot.

For several reasons, be it injuries or even minor walking/running form issues, problems with the big toe can cause a chain reaction of problems on up the leg—from plantar fasciitis to Achilles problems to calf strains and more.

When muscles inside the foot don’t work correctly, they pass a ton of strain up into the lower leg, to tissues that aren’t designed to bear the load, and things start to break down. If you don’t take full advantage of your big toe’s designed use, you could have problems on up your legs.

What can cause an “underperforming” big toe? There are several toe injuries of note that can force problems on other parts of the foot and lower leg:

  • Hallux rigidus, which causes a stiff toe joint.
  • Hallux valgus, or a bunion, which is essentially a deviated joint.
  • Turf toe, a strain of the big toe joint.

Even lesser problems, like an ingrown toenail, can cause a pain-avoiding form tweak that could stress other parts of your leg.

If your big toe is causing you pain while you walk/run, proceed with caution before you choose to work through it—or it could lead to injuries elsewhere.

If you do have persistent big toe pain, consider these ideas:

  • Rest. Always listen to your body.
  • It’s possible you have an imperfect shoe fit. Depending on the source of the pain, a shoe with a wider toe box may help ease the stress on your big toe.
  • If the problem persists, seek medical advice!

Walking and running is a simple task on the surface, but it involves all sorts of moving parts to allow for leg movement, balance, push-off and more. The big toe plays a big part in you being a fine-tuned machine—so take care of it.

Fix the toe, fix the problem, fix the symptom!

For long-distance walkers or runners experiencing pain in the joint of a big toe, the likely cause is hallux rigidus. A type of osteoarthritis, this injury can temporarily stop any enjoyable long walks or runner’s training regimen or, in serious instances, can mean a permanent end to this type of activity. Recognising this problem early will play an important role in receiving early treatment and a gradual return activity of your choice.

Definition

Hallux rigidus

Hallux rigidus is a type of arthritis caused by a wearing away of the cartilage that rests between the proximal phalanx bone, at the base of the big toe, and the first metatarsal bone of the forefoot. Each time the foot is bent, friction is caused between these two bones, gradually decreasing the toe's range of motion. This disorder usually develops between the ages of 30 and 60, however, it's unknown why some develop the condition and others don't.

Causes

Hallux rigidus mostly starts with biomechanics of the foot. People who are flat-footed or overpronate are most susceptible. Pronation refers to lateral movement of the foot from the point at which the heel strikes the ground to toe off during each stride. Overpronation is usually defined as a roll inward of 15 percent. Other causes include simply stubbing the toe, gout or structural oddities in the bone structure of the foot. Genetics may also play a role in the onset of hallux rigidus

Symptoms

In its early stages, the condition is often referred to as hallux limitus. Symptoms may appear as limited mobility of the joint at the base of the big toe. Stiffness of the joint while moving, pain on top of the toe and mild swelling are often experienced. As the injury progresses, symptoms become more serious and include pain, even at rest; limping; bone spurs; and pain in other areas of the body, such as the knees and hips, as the afflicted person adjusts to compensate for the pain.

Treatment

Treatment of hallux rigidus usually starts with footwear. Wearing shoes that have a larger toe box decreases pressure and friction on the base of the toe. Stiff-soled shoes are also recommended. However, prior to going out to buy new shoes or trainers at Healthy Harmony, we carry out a full consultation, a physical assessment and tests of the biomechanics of the foot to trace the site of pain prior to offering a full range of treatments and aftercare care.

Other options for nonsurgical treatment include nonsteroidal anti-inflammatory drugs, orthotic inserts and corticosteroid injections for pain and swelling. In severe cases, surgery may be necessary to alleviate pain.

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