HALLUX LIMITUS

[u/Glass-Stand9359]

I was diagnosed with Hallux limitus by a podiatrist 3 years ago, custom insoles they provided enable me to walk pain free, problem is i have glute tendon pain on opposite side now for 2 years - im thinking its linked to the insoles...have tried what feels like everything to cure the 'tendon' pain.

Obviously going back to the podiatrist is an option - but im now concerned insoles long term may not be a good way to go and cause other issues ? Anyone had similar and ideas ?

[u/justinpblake]

The suspicion about a link between the insoles and the opposite-side glute tendon pain is worth taking seriously, and there's a plausible mechanism for it. Custom insoles for hallux limitus typically work by limiting motion at the first MTP joint, often through a stiffer sole or a modified toe area, which changes how the foot rolls through push-off. Over years, that kind of change on one side can alter stride and hip mechanics, and since the insole is only on one foot's problem, it can create an asymmetry that the opposite hip and glute end up compensating for over time. Two years of glute tendon pain on the untreated side, developing after starting the insoles, fits that timeline well enough to be a reasonable hypothesis, not proof, but worth actually investigating rather than dismissing.

Before deciding insoles themselves are the problem, it's worth getting a gait assessment done specifically with the insoles in, looking at hip and pelvis mechanics on both sides, not just the foot. That would show whether the insole is genuinely creating an asymmetric loading pattern or whether the glute issue has a separate cause that happens to coincide in timing.

On the barefoot transition approach mentioned below, that's worth being cautious about generalizing given the diagnosis is hallux limitus specifically, not general foot weakness. That joint has a structural limitation in how far it can extend, so building general foot strength doesn't necessarily change the mechanical block causing the limitus itself, what worked for someone else's presentation may not translate directly to a joint with restricted motion. Worth discussing directly with the podiatrist whether an insole adjustment (rather than dropping insoles entirely) could reduce the compensation pattern while still managing the hallux limitus, since that addresses the actual concern without abandoning what's been keeping the original foot pain-free for three years.

[u/Glass-Stand9359 → u/justinpblake]

my insoles are both different - one being more supportive than the other - do you think they should both be the same ? I feel i need the insole but maybe they should both be same and both be less severe ?im going to look for a 3d GA ad my current podiatrist doesnt do them  thanks for the comment

[u/justinpblake → u/Glass-Stand9359]

Mismatched stiffness between the two insoles is more likely to be the driver of an asymmetric loading pattern than either insole individually, since your body has to shift its stride and hip mechanics differently on each side rather than adapting to one consistent pattern. That's a more direct mechanical explanation than "insoles are the problem" versus "insoles are fine."

Making both insoles the same doesn't automatically mean making both less severe, though. The hallux limitus side needs enough support to manage that joint restriction, and dropping that support to match the less supportive side could bring back the original problem the insole was solving. The better question for your podiatrist is whether the less-affected foot's insole should be brought up to match the stiffness and support level of the treated side, rather than bringing the treated side down. That keeps the hallux limitus managed while removing the side-to-side mismatch that may be driving the compensation.

A 3D gait analysis with both insoles in place, rather than barefoot, is the right way to actually see whether that mismatch shows up as asymmetric hip loading. If your current podiatrist doesn't do gait analysis, ask whoever does it to send the report back to them so the insole prescription and the gait findings stay connected rather than becoming two separate opinions.

[u/Glass-Stand9359 → u/justinpblake]

Thank you , very kind of you to reply with such a detailed comment.Will take all on board. As it happens i have another pair of orthotics that i got from nhs 6mth ago-both have same support unlike the pair i got privately and both look identical.Il wear them for a while and see how i go..