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Hallux Limitus

This is a diagnosis closely related to Hallux Rigidus, however, it relates to all the stages of Hallux Rigidus except the last stage - the one where the joint is 'rigid'. Hallux limitus can be structural, but it can also be functional - meaning it exists only when your foot is in certain positions.

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A man pushing a door closed on two people trying to open it. This is very similar to what happens when the toe tries to move over the arthritic joint and osteophytes 'block' the movement.

About Hallux Limitus

Hallux Limitus is a condition where the movement in the big toe joint is limited, but still present. 

It is typically caused by arthritic changes in or around the joint preventing the toe from hinging over the foot - kind of like the guy with his foot against the door. 

The other scenario is with a 'Functional Hallux Limitus' and this is where the toe joint's movement is limited during function - like if the foot is weightbearing. 

One example of how this happens is if a foot has a low arch, then the bone which the toe hinges over is at a lower angle and so the toe cannot lift over it, and at the same time, because the arch is flatter: it is longer. This means that the tendons that pull the toe downwards have no extra stretch left in them and so they hold the toe down. 

Grading Hallux Limitus

Medicine and healthcare like to give 'grades' to everything, and there are lots of different ways of measuring the severity of Hallux Limitus. In both the clinical and radiographic settings, the grades tend to have four levels, which were discussed on the Hallux Rigidus page. 

Another test which is done is to see how well the foot functions when you are standing and the big toe is passively lifted. The arch should raise and the leg should rotate. 

This isn't the case for everyone, but depending on what the foot does will also determine how the treatment plan is carried out. 

A sitting person trying to move their right big toe.
An X-ray of a pair of feet showing a bunion/hallux valgus on the left foot and a repaired bunion on the right foot.

What else could it be?

Hallux Limitus is an arthritic condition which restricts movement in the big toe joint and there aren't really many conditions that also do that, save Hallux Rigidus. 

  • Hallux Rigidus

  • Hallux (Abducto-) Valgus

  • Hallux Varus

  • Turf Toe (plantar plate rupture of big toe joint) 

  • Post-surgical complications

How is Hallux Limitus diagnosed?

Clinical examination and the history you give is often adequate: ultimately, your big toe hurts when you bend it or when you're using it! However, imaging might be used to

  • Confirm the diagnosis

  • Identify how severe the problem is

  • Rule out other problems.

  • Give consideration to types of surgery that might be helpful

Imaging that can be used for Hallux Limitus:

  • X-rays are rarely useful for functional HL.

  • Ultrasound scans can be useful for confirming osteophyte presence

A sagittal MRI image of a foot as might be used for identifying cartilage damage within a joint.
A barefoot person standing with their toes pointing skywards.

How is Hallux Limitus treated?

Treatments can take a variety of formats, each with different goals:

  1. Pain reduction

  2. Improving range of motion

  3. Restricting range of motion

The reason most people come for an appointment is because they are in pain when they do stuff, so depending on their goals, the treatment will vary. Treatments can take a variety of forms including:

  • Education & understanding the condition

  • Painkillers - including when and how to use them

  • Footwear advice

  • Insoles and orthotics

  • Taping, strapping and padding

  • Injections:

    • Steroids​

    • Hyaluronic acid​​

  • Surgery​​​

How long does it take to cure Hallux Limitus?

Hallux Limitus, unlike Hallux Rigidus is only sometimes a form of osteoarthritis, so in those instances it is a progressive condition. 

Where the limitation is functional, the 'cure' can be instantaneous - but it may rely on always having access to a support for the foot. 

Generally speaking, patients can expect to have symptoms improved quite quickly, depending on the nature of the limitation.

Lady running with her dog
Ready to say goodbye to your pain?

At Keep On Your Feet, we openly acknowledge that we cannot guarantee a cure for things: but we will work as hard as we can with you to help you reach your goals. 

If your symptoms fit the above, you will need to book a 'Foot Pain' consultation. This will be £95 and lasts approximately 60 minutes usually. If you need insoles, we'll give you some basic ones to try out (or some fancier ones and reduce their price!). 

This is a picture of Jeremy Ousey, director and podiatrist of Keep On Your Feet.

About the Author

Jeremy Ousey is the owner at Swansea's podiatry clinic: Keep On Your Feet. All the information found on this page was written by him (there's no AI or Chat-GPT here!), and has been carefully chosen to provide you with the information that you need to know about the condition. Jeremy has a Bachelor of Science in Podiatry, with honours, a Post-Graduate Certificate in Podiatric Sports Medicine, a Post-Graduate Diploma in Medical Ultrasound, and two Master's of Science degrees in the Theory of Podiatric Surgery, and Sports & Exercise Medicine. If you would like to know more about Jeremy, please click here.

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