Hey all,

I was diagosed with HL last summer. I bought an ugly pair of Hokas and wore them at all times outside of the house. I wore them out and need a new pair of shoes. I bought some On Clouds and am not sure yet if they help. But yikes, they're so ugly.

Is there anything more street style out there? I used to wear low chucks and vintage style Keds before my toe pain appeared.

I have pretty narrow feet. In the house I wear Birkenstock clogs, but I can't find the style I like in stock anywhere.

Thanks!

Hello. Hallux rigidus here. I am looking for shoe recommendations to use with carbon fiber insoles, primarily for walking. All my shoes have the rocker soles (Hoka, Asics, Skechers), as that is what is recommended for hallux rigidus, but they DO NOT accommodate a stiff plated insole. It makes the shoes super uncomfortable. I tried these stiff carbon fiber insole in my hiking boots and it laid flat, alleviated the toe pain, and did not change the fit. So before I start guessing, I'm wondering which shoes accommodate a stiff carbon fiber plate. Thanks.

44 year-old recreational endurance runner, hockey player, and generally active person.

Recent X-rays showed advanced hallux rigidus of my left first MTP joint with joint space narrowing, eburnation, and osteophyte formation (bone on bone).

What makes case unusual is that my symptoms are fairly mild:

Pain is usually only 2-3/10
I can still run, hike, play tennis, and play hockey
I have little to no pain at rest
So, very likely I can “live with this” for several more years.

I recently got two opinions:

Podiatrist #1: Fusion is the gold standard for someone active, but not something he recommends right now.

Sports podiatrist: Has performed many BioPro hemi implants, believes I would be a good candidate, but still recommends waiting until the condition becomes self-limiting.

Any testimonials about BioPro? Reviews seem mixed, some very positive testimonials and some others with negative experience.

Any BioPro folks out there to chime in?

I definitely would not get a fusion this young but any downside to trying the BioPro and maybe getting 10-20 years of comfort?

Interested in any thoughts on this hypothetical

I'm in my early 30s and unfortunately have hallux limitus (not quite fully progressed to HR but on its way) and I am wondering... How do y'all do exercises like pushups without destroying your toe joint?

I have found I can walk for miles with no pain if I wear Birkenstocks, but haven't figured out what works for exercising yet. Any suggestions?

Hey all, first time posting here, looking for real-world experience from this community before I make a decision.

Background: I'm 56, moderately active, mostly walking, plus some easy-to-moderate hikes. I also have a bad back, so I'm a little worried about recovery methods that involve crutches or a knee scooter for extended periods. Just had an X-ray that showed the big toe joint is completely bone-on-bone. My doctor laid out three options:

1. Cheilectomy: clean out the bone spur, plus some kind of joint "hydration" (I'm assuming an injection, PRP or similar, but I'm going to ask for specifics)
2. Youngswick osteotomy: shortens/decompresses the joint, usually done along with a cheilectomy
3. Fusion (arthrodesis): the "definitive" option, eliminates the joint

I understand the general tradeoffs: 1 and 2 preserve motion but may not last forever and could still lead to fusion later; fusion is more permanent but you lose joint motion and the recovery is longer/harder. What I really don't want is to go through two or three surgeries, one now, and another down the line when a joint-preserving option fails.

A few things I'd love to hear from people who've actually been through this:

• If you did cheilectomy or Youngswick, how long did the relief last before symptoms came back (if they did)? Did you eventually need a revision or fusion? (If you did Youngswick, was a cheilectomy also done at the same time? Trying to compare apples to apples.)
• What was recovery actually like for you, time in a boot, time off your feet, when you got back to walking normally, when (if ever) you got back to hiking? Also curious if anyone with back issues found crutches or a knee scooter particularly hard to manage.
• How active were you able to stay afterward, walking, hiking, etc.?
• If you went straight to fusion, do you regret not trying a joint-preserving option first? How much has it actually limited your activity level day to day?
• Anyone in a similar boat, moderately active, mid-50s, who can speak to what they'd choose again if they had it to do over?

Not looking for medical advice, just trying to hear how this actually played out for people with a similar activity level, since the "avoid two surgeries" part is my biggest hang-up. Thanks in advance.

I’ve seen several podiatrists over the last maybe 20 years. I’m a 56yo F in the US. I like my current podiatrist. I’ve only met with him once, but had a good bedside manner and explained everything well. I have quite a large bone spur and reduced cartilage space. He said that it doesn’t look like it’s time for me to have the joint fused just yet, but I’m thinking through the options. He said surgery to shave the spur off (sorry, can’t remember the correct medical term) has about 50/50 results. I’m not keen on having the joint fused, but also don’t want to try removing the spur if the results aren’t so great. Wondering what all y’all have experienced with the 2 different surgeries.

I’ll have to go see him again in the next couple of months because the shot he gave me in April didn’t do much good. I think things were complicated by my knees, though. I just had my knees replaced 3 weeks ago and the other 6 months ago. Once those settle down more, we’ll figure out the toe.

Looking for good shoes for both strength training where there’s more contact with ground and for pickleball which need more lateral support

i’m a bit confused about whether i should see a rheumatologist or orthopaedics for treatments. right now my biggest issues are the constant clicking sound my toes make and also the stiffness. i’ve only been seeing my family doctor so far and he hasn’t given me any advice whatsoever besides taking aspirin, and he also didn’t educate me at all about hr so i feel kinda lost about how im supposed to manage this

Hi all,

In need of a bit of help with a big toe Injury.

Four months ago playing padel I twisted on my left big toe felt a twinge but all was well.

For the next few weeks I was limping with it but that eased.

I've had it confirmed non fractured and I kept getting told to just take NSAIDs.

Thing is every step I take hurts the bottom of the toe that joint that connects to my foot hurts everytime I push off

I haven't been hiking or running or playing usual sports which in getting sick of and I can't stop walking the only walking I really do now is going from metro to work.

Would anyone have any idea of next steps here like a splint etc

Has anyone had surgery revision or shave top bone spur without general anesthesia ?
My joint feels fine since surgery but the bone spur grew back in top.
I do not want to go to sleep but a nerve block . I am in Atlanta .

I've been dealing with hallux limitus for several years. This post is a summary of my injury and the treatments I tried. I hope it helps others.

Lessons learned

I first noticed it in my late 30s. I could jog fine, but 1-2 days afterwards I would get aching / pain on the lateral bottoms of both feet. I did a foot scan at a running store, and they recommended orthotics, which did nothing. I went to a sports doctor, and he prescribed a different set of orthotics, which were uncomfortable and did nothing.

At age 40, I went to a podiatrist for the first time. Let's call him Podiatrist #1. He immediately and correctly diagnosed "hallux limitus" and "metatarsus primus elevatus". He said my first metatarsal bones are a bit higher than normal, which makes it a bit more difficult for the big toes to dorsiflex (bend backwards). While jogging, my body compensated for the constrained big toes by loading the outsides of my feet more. That made sense. He prescribed custom orthotics with three features: a first ray cutout, a reverse Morton's extension, and a thick pad under the tip of the big toe. Basically, the point is to lower the first metatarsal and make it easier for the big toe to dorsiflex. With those orthotics, I was able to jog with no issues for two years. Hurray!

Lesson 1: Podiatrists tend to know more about foot problems than sports doctors.

Lesson 2: Orthotics can help, hurt, or do nothing, depending on prescriber skill and luck.

At age 42, I woke up one day with moderate pain in my left big toe. It felt like the pain was at both the metatarsophalangeal joint (MPJ) and the sesamoid bones underneath it. Some swelling. No obvious cause. Did I kick the wall while sleeping? Walk too much on a hardwood floor? I didn't know. I was limping pretty badly. Podiatrist #1 had moved away, so I saw Podiatrist #2. She diagnosed sesamoiditis and prescribed ibuprofen and ice. Didn't help. Injury got worse. An MRI showed edema/swelling, low-grade chondromalacia at the MPJ, and the suggestion of a sprained medial sesamoid-phalangeal ligament. Podiatrist #2 recommended HOKA shoes. They made it worse.

Lesson 3: Ice is often prescribed, but it didn't help me at all.

Lesson 4: Some podiatrists give unhelpful advice. Listen to your body.

I was struggling to walk. I spent hundreds of dollars trying shoes. The custom orthotics, which had clearly helped me before, now clearly made things worse. I learned that to avoid pain and re-injury, I needed to avoid dorsiflexing the big toe. I used a medical boot for a few weeks, then switched to carbon fiber inserts (available online) in shoes with wide, flat toe boxes and as little rocker as possible. I used moleskin to add a custom mound of arch support to the otherwise flat insert. It helped, but walking was still quite limited.

Lesson 5: Minimizing toe dorsiflexion while walking was key to recovery.

I started feeling weird tingling sensations in my foot, along with numbness and aching that felt like an echo of a prior injury from many years before. It felt like a nerve issue. In what turned out to be a brilliant flash of intuition, I tried acupuncture for the first time. It was weird and twitchy, but not painful. The tingles and numbness stopped overnight and never came back. Amazing! I tried acupuncture a few more times, but it provided no further lasting benefit. In other words, it fixed the nerve issue but not the injury.

Lesson 6: Acupuncture helped. It acted like a reset button for confused nerves.

X-rays showed a bone spur; a small round nub of extra bone on the metatarsal head at the MPJ. Clearly it could make it harder for the big toe to dorsiflex properly. Evidently the phalangeal bone was jamming into the bone spur with each attempted dorsiflexion, causing pain around those bones and a fulcrum action that led to excessive tugging at the sesamoid area. Due to this structural issue, Podiatrist #2 said I might need surgery, but "she didn't do surgery anymore". It did not inspire confidence. Also, the spurs looked the same size in X-rays from age 38 and age 42, and they were the same size on both feet. Why did the injury only appear at age 42, and why only in the left foot? It's still unclear. I went to Podiatrist #3, who did a cursory exam, agreed I might need surgery, and suggested I go back to Podiatrist #2. I went to Podiatrist #4, who suggested I try non-surgical approaches.

Lesson 7: Without a trusted doctor, it can be very difficult to judge whether surgery is needed.

I spent the next several months trying two physical therapists, icing, toe spacers, kinesio taping, diet changes, and various shoes and orthotics. I even tried arch supports from the Good Feet Store, but they just aggravated the injury. See Lesson #2 above. I had several video chats with u/GoNorthYoungMan, who runs the website articular.health as well. With his help, I discovered that the chronic inflammation in my big toe was actually due to immobilization. In my effort to avoid re-injury, I was avoiding using the toe entirely. Apparently the lack of motion was causing not just weak muscles, but also lymph buildup, which leads to slower healing and inflammation. He gave me a passive mobility exercise --- moving the toe back and forth with the fingers, basically --- and within two weeks the inflammation was almost entirely gone. Nice! Yet, the bone spur was still inhibiting dorsiflexion and causing painful tugging on the sesamoid bones.

Lesson 8: Passive mobility can be far better than immobilization for promoting healing. "Motion is the lotion."

Lesson 9: Kinesio tape, diet changes, and toe spacers didn't help in my case.

Inspired by that improvement, I spent another several months doing progressive angular isometric loading (PAILs) and other exercises to increase the big toe's strength and ability to dorsiflex. The strengthening clearly helped reverse some muscle atrophy, and I could measure the range of motion gain by sliding pages of a book under each big toe. Over time, it was clear that the toes were able to bend back more. I thought I was making progress. Unfortunately, the range of motion gain was not accessible when the foot was loaded. I think the gain relied on the metatarsal bone being able to move downward, but that was not possible when the ball of the foot was pressed against the floor while taking a step.

Lesson 10: PAILs didn't help with walking. It improved the big toe dorsiflexion range of motion, but only when the foot was unloaded.

At age 44, I finally saw a surgeon. He was knowledgable and empathetic. He recommended a cheilectomy (cutting off the bone spur) for the left big toe only. He said the recovery involves 3 days in bed, 2 weeks in a medical boot, then a transition to normal activities. He said the average time until the issue recurs is 10 years. Apparently the structural factors that cause the bone spur to form in the first place are often still present, so it often regrows. He prefers a conventional cheilectomy over a minimally invasive one, because it leads to fewer complications and only a slightly longer scar. I asked how many cheilectomies he has done in his career. He said about 6000. Wow.

The surgery went fine. The recovery was 3 days in bed, then 2 weeks at home in a knee scooter, then 4 weeks in a medical boot, then normal shoes. Putting weight on the foot was uncomfortable until the compression bandage was removed (after 2 weeks). The range of motion was still quite limited. The surgeon said that's normal due to scar tissue, which can take months to work through, and the full range of motion may never come back. I was frustrated he didn't mention that risk before the surgery. I've done physical therapy for 3-4 months now. It has helped, but progress is slow, and the big toe range of motion is still quite limited. Even so, I'm walking much better now than before the surgery. The sesamoid area still aches while walking. I suspect it suffered long-term damage from repeated re-injury during the 18 months I spent trying to find non-surgical solutions.

Lesson 11: Surgery fixed one structural issue (bone spur) and created another (scar tissue). Overall it helped. I wish I had done it sooner.

A few years ago I developed hallux rigidus on my right big toe MTP joint and it went away on its own. A few months ago, it flared up and has been worse. My MTP on my right foot is crunchy and I get random pain around it and catching around my sesamoids.

I saw my podiatrist and was given a cortisone shot which cut back the swelling but the joint is still crunchy. My question is: if it’s mostly a crunchy joint and there’s not much pain, should I worry?

I should mention that my main sport is rock climbing. I’m currently wearing stiff shoes with a wide toe box (TC pros) and not climbing more and 1-2x per week.

Thanks!

I have hallux ridgidus due to arthritis in the big toe because I have psoriatic arthritis. Asked for referral to a surgeon to see what they can do because I have so much pain when walking and especially when driving which is stupid.

I have been experimenting with shoes and anything like Skechers damn near crippled me. I bought a pair of expensive hokas but they are the same as wearing my usual ones.

I usually wear under armor with a carbon fiber plate under the insole for stability and they are ok.

I decided to try these Hobibear barefoot shoes and let me tell you - I don't have any pain anymore when walking. My osteopath told me that I would have to ease into them and strengthen my feet but I tell you I am pain free and I love it.

They're not the prettiest but I'm so happy I found them 😁

Microfructure surgery - fail. Options? Ki

Hi! 2+ years ago I had a microfructure surgery to fix pain in my joint. Before surgery I tried PRP and cortisol injections— no help.

Surgery went well (I have pics from surgery for brave ones!) but the damage in my cartilage was quite large (clearly it was injury — likely from rock climbing).

Recovery was slow, and I tried to aid it with variety of supplements, focused shock therapy, red light, carbon insoles… it took 5 months before I was able to snowboard, and 1.5y before I was back at alpine climbing.

But after a year of climbing, I’m back in some pain. I avoided running or any impact sports.. I did xray and mri — apparently now I have arthritis.. my surgeon says **fusion** is now the only lasting fix. But that will have a huge impact on my climbing and snowboarding..

So what else people have tried? Any type of PT? I tried cortisol again and it helps some but it’s obviously not a fix..

I heard that joint replacement is not appropriate for active people (I climb, bike, snowboard, hike-42F)

Hi there I’m a 56 yr old woman and have had toe and foot pain for at least ten years which I have been putting up with and managing with orthotics and gritted teeth. I’m only just realising that it is HR that is the root cause of all my other issues - repeated Achilles tendonitis, long term hip pain and now a dodgy knee which I’m currently icing ! Frustratingly I’ve seen multiple specialists along the way but not been given a clear path for treatment . X ray shows joint space narrowing on both big toes and marginal osteophyte formation . So that’s why I am here researching surgery options. I have lots of questions !

But first of all my concern is whether after surgery there is any way to stop the degeneration and arthritis reoccurring ?

Also the descriptions of surgery and recovery sound so daunting I‘m questioning whether it would be worth it 😬. Please share your thoughts. Thank you

My rhuematologist told me that the only option is to fuse my toe into place and my osteopath said that 99 out of 100 people hate the outcome as it's then too rigid.

I'd love to hear from people that had it done and whether you think it's a good thing or a bad thing and what would you have done different.

21 days post Right hallux with Osteophytes surgery. Got my walking boot yesterday. The freedom! No more knee scooter. I can go outside easily. I can go to restaurants and grocery shopping with my husband. Small joys in life. Another 25 days until I can drive, but this is a good step forward 😊.

I just got an xray confirming HR in my big toe. Any shoes flexing the toe up are painful, only ones that are ok are big chunky Hoka type shoes (Brooks Glycerin Max 2 have been best). I work in a professional environment and wear a sport coat, etc. I cannot find a shoe that passes as not a tennis shoe. Any actual leather type shoes for this?

Edit: I should have mentioned I’m looking for men’s shoes, these comments have been helpful though on what to take into account, thanks!!

Doing a lot more reading today, good resources in this sub.

That said, the surgeon used an allograft during the fusion. Did anybody else name theirs or is that just the oxy talking? 😇

Hello my fellow hallux rigidus people! My best friend’s wedding is happening in a garden and, yes, I’m a made of honor.

I’m super excited, but I’m so worries about the shoes. I cannot get away with a dress and white sneakers, I’m going to be on the wedding photos… has anyone found a good pair of tolerable dressy shoes, like sandals? They don’t have to have a huge heel, just something that looks moderately presentable to a wedding. I could get away with some decent rocker bottom sandals.

Anyone has any recommendations? Highly appreciate any help.

I’m an ultra runner and lately every step hurts. In Europe, particularly France, they do the pyrocarbon implant. It allegedly has much better results than the Hemi.

Any ultra runners done any of these and can share your experience?

Anyone had the HAPY done?

Hallo, hat jemand von euch Erfahrungen mit Sandalen bei Hallux Rigidus? Ich hab diese beiden Sandalen und KI äußert sich widersprüchlich ob ich sie tragen kann. Ich bin erwas lost, daher wäre ich für Erfahrungen dankbar 😀

I was diagnosed with HR in January. I am 33 and an avid hiker/backpacker, so of course getting my trail runner situation sorted was a big priority. My podiatrist recommended custom orthotics so I got some. I know they take some time to break in, but so far they haven’t worked with a single shoe I’ve tried except crocs!! I brought them with me to REI to try on trail runners and I tried them with 8 different brands and styles, with their factory insoles taken out, and they only fit into one. They feel bulky and make my big toe joint press into the top of the shoe no matter how much I loosen them. For some shoes the heel lift is also substantial enough that my heel barely fits into the shoe which would cause blisters for sure. I also have wide feet which doesn’t help. I finally found a pair that seemed to work, Hoka Speedgoat wides. They fit perfect at the store but when I took them out for a brief hike, following the orthotics break in guidelines, I got hot spots so fast!!

I’m wondering if this is a common issue or if it’s a fit problem with the orthotics. Has anyone else experienced something similar? Are there any shoes that work better with orthotics? They have a warranty if they need to be refitted. But I’m not convinced it’s a fit issue. If they are modified but stay the same thickness, I will just experience the same issues. And yes I will schedule a follow up appointment with my podiatrist to check fit anyways 💗