Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Qustion for doctors about hallux limitus?

Posted by Lynn M. on 8/02/04 at 07:35 (156748)

Drs. I can only pull my big toes back about 20-25 degrees and my new podiatrist says thats its hallux limitus. He explained that my big toes were longer than my second toes and he said that this is considered royalty, usually the second toe is longer. Well he did x-rays, but i won't know what they showed until my next visit. Can you tell me what the x-ray tells you about this condition? Thanks

Re: Qustion for doctors about hallux limitus?

Pauline on 8/02/04 at 09:35 (156751)

Lynn,
I'm not a doctor, just a former P.F. sufferer. Having never experienced hallux limitus, what symptoms you were experiencing that made you go to the Dr.

The part about royalty is interesting. I wonder if that went back to foot binding or if many royal families experienced this condition and why.

Re: Qustion for doctors about hallux limitus?

Ed Davis, DPM on 8/02/04 at 13:28 (156764)

Lynn:
Hallux limitus is a restriction of motion at the big toe joint. What type of symptoms do you have?
Ed

Re: Qustion for doctors about hallux limitus?

Lynn M. on 8/02/04 at 16:10 (156772)

The pain i am having started a couple months ago it kind of felt like a bruise under my big toe joint.soon the pain became sharp-it feels like i have pf at my big toe joint(where the sesamoid is-the tendon that attaches there is real tight). The first dr. i saw said that it is probably pf- keep stretching. Now i can hardly walk.
The new dr. tried to stretch my big toe back and it doesn't go back to far, he said that it is most likely hallux limitus and that i might need surgery. He took my over the counter inserts and cut away what he called the 1st ray, where the big toes lays and he raised my heel and midfoot with some sticky felt. It does help the big toe, but hurts my heel-I'm sure its just the way it is positioning my foot, i would guess a custom orthotic will feel much better. I can't help wondering what the x rays will tell him.Could you explain? Thanks.

Re: Qustion for doctors about hallux limitus?

Ed Davis, DPM on 8/02/04 at 19:07 (156783)

Lynn:

X-rays will help determine if and how much cartilage may be worn away from the big toe joint. Also they may show if extra bone has formed that may be blocking motion.

Orthotics can help in some circumstances and hurt in others. The doctor must first determine to what degree the limitation of motion is position dependent, that is, to what degree is it possible to increase the range of motion of the joint by changing its position. If an orthotic is designed to try to place extra motion in a joint that will not move more when 'repositioned,' that is when they can be harmful. This is something that is easier to show on models of the foot, not easy to describe in words.

If the limitation of motion is structural, that is, not position dependent, then surgical treatment is more likely to be needed. PF can be worsened by hallux limitus because changes in gait caused by inability to bend the big toe joint place the plantar fascia in a position of more stretch/tension. I feel that a good range of motion of the big toe joint is very important and this is an area in which I tend to move in a surgical direction more agressively than most other foot problems.
Ed

Re: Qustion for doctors about hallux limitus?

Lynn M. on 8/03/04 at 09:07 (156812)

Dr. Ed, Thank you very much for your response. I think i understand what you are saying. From my description, does it sound like hallux limitus to you? i am very leary at this point because the first doc i saw didn't pick this up. He also took x rays so i'm hoping if there were structural damage he would have seen that?