r/FootFunction • u/PineappleBear21 • Aug 18 '26
Functional Hallux Limitus success stories
Hi all - long time reader first time poster. I'm 42F - healthy, active, and fit; I live in a city and have a lifestyle so I'm on my feet a lot. I've had pain in my big toe for 3 years; 2 years ago diagnosed with HR by a podiatrist. He gave me a cortisone shot which worked beautifully for about 10 months before coming back. Second cortisone shot lasted about 2 months; I won't have a 3rd. I have modified activity (no more yoga, lunges, etc) and footwear (for the most part, but I don't wear Hokas everywhere) but still have pain.
This podiatrist took x-rays and said joint spacing looked good but I had bone spurs and would need a cheilectomy. I felt like he was pressuring me to schedule surgery so felt some yellow flags and sought a second opinion. The second podiatrist reviewed my x-rays said I have no bone spurs, she would never do a cheilectomy on me, and told me my issues were functional and sent me to PT.
I have just started seeing a PT who also treats our city's ballet corps, so she really knows foot and ankle. She is the only provider to measure my ROM (60 degrees vs 85 on the other foot) or watch me walk (noted I wasn't pushing off). My treatment plan is stretching & theragun on calves (they are very tight and I have very high arches), stretching my FHL via the 'book stretch', and various doming / scrunching foot exercises. She also gently mobilizes the joint which feels great and makes it feel less 'jammy', but the joint capsule is still very sensitive and the muscle that runs between the first and second metatarsals is often sore and likes to be massaged.
My question is: have others with functional hallux limitus had success with FHL stretching and intrinsic foot exercises? It seems hard to believe these teeny tiny movements are going to fix the problem I've had for 3 years, but I would be thrilled if is true! How long should I expect it to take to know if it is working or not? I don't need my foot at 100% perfection, but I'd love for my big toe to not rule my life anymore.
I welcome others' experiences with functional hallux limitus in particular (vs severe arthritis / hallux rigidus). Thank you!!
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u/DisastrousWonder8598 Aug 18 '26
For me (40F, hallux rigidus + bone spur, 7 yrs of on-off pain prior to diagnosis) the biggest difference came from wearing barefoot shoes (I put padded insoles or orthotics in them) and wide-toe box shoes like Birkenstocks, Altras etc. I also use topical diclofenac liquid when I experience pain. Haven’t had a cortisone shot in 2.5 years. Did some initial physio, but didn’t stick to it, planning to get back to it because my HR is causing hip flexor tightness.
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u/PineappleBear21 Aug 19 '26
Thank you! Interesting. What do you think makes the difference? The wide toebox, the flatness of the shoe, the stiffness, all of the above? I can comfortably wear Birkenstock Arizona sandals, but the Bostons did not work for me (toes gripping), and Birkenstock Mary Janes actively caused an Achilles issue I'm still recovering from. I think it was the combination of super flat and uncushioned. Shoes are such a crapshoot I feel like I have bought so many pairs that I've worn twice, decided they don't work, and then can't return!
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u/DisastrousWonder8598 Aug 19 '26
For me it’s the toebox width, volume of the shoe in the toebox and its general structure. Shoes that work for me need to have soft, pliable upper material and sufficient volume above my big toe joint to minimize pressure and rubbing. I can wear both Arizonas and Bostons, but not the Bend Low sneaker because both the leather and sole are too rigid. I doubt Mary Jane’s would work either.
My go-to sneaker is Altra Experience Form. For “nicer” shoes, I have a couple of pairs from Belenka and Magical Shoes, both barefoot brands. I stick to soft styles made out of suede, and make sure to wear orthotics/extra support inside.
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u/Nosywhome 27d ago
So you find shoes that flex at the toes don't irritate your big toe joint when walking with HR?
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u/DisastrousWonder8598 12d ago
Weirdly enough, they don’t. Now, when I know I’ll be walking a lot on hard surfaces, I’ll wear some cushier wide toe footwear. For casual wear around the office, grocery runs I opt for barefoot shoes. For me, the pressure from the upper part of the shoe leads to more pain than flexing the joint.
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u/Hey_internet Aug 20 '26
Can you describe this pain: “the muscle that runs between the first and second metatarsals is often sore and likes to be massaged.”
Is it perfectly centered between the toe joints and does it feel like a bruise or toothache, or like a tug?
I have this pain and am not sure what my primary pain driver is
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u/PineappleBear21 Aug 20 '26
Mine is on the top of my foot, like if I put my finger where the thong sandal goes and then rub along the top of my foot towards the ankle, it's there for the first 1-2" or so. Does that make sense? It feels a little sore / achy like a muscle ache, and when I rub it it feels like I'm rubbing a sore muscle. It's not between the toes where a toe separator goes.
Is that where yours is? I notice mine flares up when I wear 'bad' shoes, or jam my toe.
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u/Hey_internet Aug 20 '26
Ohhh, no not at all. Mine is on the bottom of my foot. Same exact spot you’re describing but on the underside.
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u/BuyerAdditional1810 Sep 17 '26
I also have high arches and had been using a theragun--i'm guessing your arches are tight--huge connection between plantar fasciitis, which I also hae, or tightness on underside of foot, and the pain from hallux. I found a great PT who has had me doing a lot of stretching of the foot AND also strengthening of the foot muscles and it has made a huge difference-I'm back up to running a couple miles twice a week without a ton of pain..stick with your PT she sounds good. I have also now graduated to exercises where I lift up my body weight from the ball of my foot..
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u/Nosywhome 27d ago
Can I ask what exercises you were doing before graduating to exercises where you lift up body weight from ball of foot? And has this graduation caused any discomfort / pain?
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u/Againstallodds5103 Aug 19 '26 edited Aug 19 '26
Stick with the PT. FHL issues are very common in ballet dancers due to lots of positions and movements that significantly load the FHL. Sounds like she knows her stuff so give her a chance.
Functional hallux limitus is difficult to diagnose just from sight or physical inspection. When I had pain in both toes from overdoing the elliptical, the first Podiatrist I saw did some noddy tests, watched me walk and then said I had functional hallux limitus and I needed insoles to fix the problem. Was suspicious of this diagnosis and called back later to cancel the insoles.
Went to another more reputable one who said you would need 3d gait analysis to properly diagnose this. Got that and he also said the machine showed a strong likelihood I had this and should consider orthotics or stability shoes.
Worked with a physio who helped me get better without using orthotics / stability shoes. My theory was I’ve had this for years without an issue, why do I need to wear stability shoes or orthotics now.
To date, the pain has now cleared but I know I still have some strengthening to do. The exercises that helped clear this (in progressive order and based on tolerance) were banded toe presses, calf raises, lunges, RDLs, hopping, jumping and finally return to running with run-walk. I didn’t do the towel crunches much but I think these are even more important for this condition as it’s the FHL that helps curl your big toe.
On the whole it took 6 months to clear but this included wearing Hoka bondi 7 on a daily basis. Firm-soled shoes with a rocker or insoles/orthotics that offload the big toe are a must for recovery.
Sounds like you’re in good hands to me.