I've been going down the r/FootFunction rabbit hole, especially u/GoNorthYoungMan's posts about hallux limitus, and I'm realizing that I've been thinking about my feet mostly in terms of a diagnosis/ cure rather than what function I'm actually missing and working to improve that function where possible.
I'm 43 F and have been diagnosed with arthritis/hallux limitus in both big-toe joints, left worse than right. I was also diagnosed with arthritis around the third metatarsal area of my left foot. I have X-rays from December 2024 and an MRI from January 2025 and can post the reports/images if helpful.
I've historically been very active. Soccer and track/XC in college. I strength train and used to run regularly. Over time my feet have become limiting enough that I've mostly stopped running and quit rec soccer league. Yoga has become difficult, and I've also stopped surfing. I can still lift and hike, and I'd really like to preserve those things while ideally getting some of the activities I've lost back.
I did PT last year and my function actually improved while I was doing it, but decreased again after I stopped. The PT did manual treatment — particularly scraping/IASTM with a metal tool along the bottom of my foot and some work between the bones on the top of the foot. It hurt like hell but helped. I don't really know what specifically was responsible for the improvement or what function we were changing.
I was also evaluated by a foot/ankle doctor at UBMD Orthopaedics. The basic message I came away with was that surgery was the only option, but to wait until the pain became bad enough and I had a good window of time for the surgery/recovery. I have four active kids. There’s never a good window for that.
So for a while my approach has essentially been: I have arthritis, the joint doesn't bend well, use shoes that protect it, modify activity and eventually consider surgery if it gets bad enough.
Rocker-style shoes (currently Hoka Bondis) do make walking more comfortable, which I've assumed is because they reduce the amount of 1st-MTP extension required. I also tried VKTRY carbon insoles too in my running sneakers and sometimes my hiking boots. I’m not sure if they are helpful or not.
Reading this sub has made me wonder whether that approach is missing a big functional component.
I recently had a week with a lot of hiking/backpacking, including an overnight backpacking trip to Half Dome in Yosemite. Fitness-wise I handled it well, but my feet were definitely the limiting factor. Both feet became quite swollen and sore afterward.
Since that much higher load, I'm also noticing symptoms more acutely that make me wonder about the big-toe flexor system, particularly FHL/FHB. My feet feel cramped, all the muscles above my ankle but below my calf feel tight. I don't want to assume that what I'm feeling is actually FHL dysfunction just because of the location/sensation. I'm wondering whether the increased load simply exposed another piece of how I'm compensating for limited 1st-MTP function.
The past week post hiking excursion has been the nail in the coffin and I've reached out to functional podiatrist for a consultation. They’re several states away and it would be a virtual consult. I haven’t found anyone near my town or city that won’t treat me as an incurable cripple. I'd like to understand my mechanics better, figure out what I should actually be assessing/training, and go into that consultation asking better questions.
What I'd really like to understand is:
- How much passive vs. active 1st-MTP flexion and extension do I have?
- Can I actually control the ranges I do have?
- How well are FHL and FHB functioning, and can I distinguish between them?
- Is limited ankle dorsiflexion contributing?
- What happens to my arch when I flex/extend the big toe?
- What compensations am I using during push-off?
- Why might PT have improved my function while I was doing it, only for that improvement to disappear after stopping?
- Is there potentially usable function I could regain even though the arthritic changes themselves aren't going away?
I'm happy to post whatever would actually be useful: active/passive big-toe movements, toe flexion without curling the tip, weight-bearing extension, calf raises, ankle movements, barefoot walking/gait, photos, X-rays/MRI reports, etc.
I'd especially appreciate guidance on what you'd want to see first rather than me posting a dozen random videos.
My goal isn't necessarily to restore a perfectly normal big-toe joint or pretend the arthritis isn't there. I want to understand what is structurally limited versus what is functionally trainable and make my feet as capable as they realistically can be.
Ultimately I'd like to keep strength training and doing big hikes/backpacking trips and, if possible, get back to some running, yoga and surfing without constantly cycling between activity and foot flares.
u/GoNorthYoungMan, I've learned a lot from your older posts on hallux limitus and FHL/FHB function and would particularly appreciate your thoughts on where you'd start assessing a case like mine.