Index
The hallux limitus is the limitation of mobility of the joint formed by the phalanx of the first finger with the first metatarsal (metatarsophalangeal joint). This limitation of joint mobility causes pain and consequently a decrease in the activity of the person suffering from this problem.
The hallux limitus usually appears in young people and with the passage of time it transforms into a hallux rigidus, which is why it is sometimes considered an initial stage of joint degeneration of the metatarsophalangeal joint of the first finger. The metatarsophalangeal joint of the first toe is made up of the first phalanx of the big toe and the head of the first metatarsal.
The first toe together with the first metatarsal form a functional unit of the foot called the first radius. This first radius is a fundamental part in the development of human gait and allows the foot to support the weight of the body during its propulsion phase, which consists of the first toe taking off from the ground.
During the take-off of the first toe from the ground in the march, this toe must support a load equivalent to 2 or 3 times the weight of the person, which means that for a man weighing about 70 kg, at the time of take-off it is joint can support about 200 kg in just a few square centimeters, which suggests the enormous pressure that must withstand at this moment.
The foot is structured to withstand these pressures and especially the first spoke, which is the most robust and the largest. However, when there are diseases such as hallux limitus, this joint loses its effectiveness, which causes an imbalance in the distribution of loads to the rest of the foot, injuring other areas of the foot that are not adequate to withstand such pressures and initiating the pathological process that surrounds it. to this alteration.
Causes of hallux limitus
The cause of hallux limitus is still 100% undeciphered. However, there are a series of factors that are associated with its appearance and which are the following:
- A longer or elongated first metatarsal, which is known by the technical name Index Plus.
- Structural or acquired dorsiflexion of the first metatarsal. This means that the first metatarsal is elevated relative to the ground plane, limiting the normal range of motion of the metatarsophalangeal joint.
- Congenital structural alterations of the first metatarsal.
- Foot muscle imbalances.
- Hypermobility of the first radius associated with pronation of the subtalar joint.
- Neurological disorders, which can cause spasticity of certain muscle groups in the foot.
Production Mechanism
One of the main causes that develop the pathological process of hallux limitus are biomechanical alterations of the foot. The pronation of the joints of the posterior part of the foot causes hypermobility of the first metatarsal, developing a muscular imbalance that limits the movement of the phalanx of the first toe on the first metatarsal.
A longer first metatarsal causes it to collide with the phalanx of the first toe and therefore limits the movement of this joint, making its function less effective in the development of human gait.
The conclusion would be that a structural or functional alteration of the foot prevents achieving the maximum range of motion between the head of the first metatarsal and the base of the phalanx of the first toe, that is, there is a functional limitation to joint movement. This circumstance develops degenerative processes in the joint over time, which gives rise to Hallux Rigidus .
What symptoms appear?
The symptoms of hallux limitus are:
- Decreased joint mobility.
- Localized pain in the first metatarsophalangeal joint. The pain increases with physical activity and walking.
- Acute pain in the extension movements of the metatarsophalangeal joint.
- Palpable swelling at the level of the joint.
- Redness of the joint area.
- Appearance of a callus on the big toe in the inner plantar area of the foot, which coincides with the joint formed by the two phalanges of the toe. This callus appears due to the translation of loads at this level due to the difficulty of being supported by the rigid metatarsophalangeal joint.
- Elevation of the big toe as a muscle compensation mechanism.
- Pain in the sole of the foot especially under the head of the second and fifth metatarsals.
Diagnosis of hallux limitus
To diagnose hallux limitus, a complete medical history and physical examination are necessary.
A radiological study is necessary to observe the bone state of the metatarsophalangeal joint and its structural arrangement.
Biomechanical analysis is essential to assess the person’s gait and assess the development of the gait. There are computerized plantar pressure analysis systems that allow us to observe the functionality of the first metatarsophalangeal joint during gait and the behavior of the rest of the foot in compensation for the limitation of movement of this joint.
It is also interesting to perform an assessment of joint movement accompanied by a muscular balance that allows us to evaluate this affectation.
Treatment
Treatment of hallux limitus will be aimed at reducing the symptoms caused by joint inflammation, as well as compensating for the biomechanical problems that occur in this type of foot. Pharmacological treatment consists of the administration of non-steroidal anti-inflammatory drugs (NSAIDs) that reduce inflammation and pain.
The biomechanical compensation will be carried out through the establishment of an orthopedic treatment that will consist of an orthopedic insole that helps the foot to function properly and balanced. On occasions, this treatment can be accompanied by external modifications to the footwear that help to achieve a natural gait.
How to avoid it?
To prevent the appearance of hallux limitus we will have to follow the following tips:
- Go to the podiatrist if we notice pain in the big toe joint or limitation in movement. This professional will be in charge of evaluating the condition of our feet and establishing an orthopedic treatment that prevents the progression of the disease.
- Avoid wearing high-heeled shoes that can increase pressure on the first metatarsophalangeal joint.
- Follow an appropriate training plan when playing sports that can damage the foot at this level. For example: soccer, polysalt sports (basketball, volleyball …).
- Perform foot examinations in case of suspicion of any symptoms related to hallux limitus.
Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.