Therapy | Exercises for metatarsophalangeal joint arthrosis of the big toe

Therapy

Before the hallux rigidus is surgically treated, there are a variety of therapeutic options. In addition to mobilizing techniques, traction in particular is used in physiotherapy. This is a technique from the field of manual therapy.

The joint surfaces are loosened slightly from each other by light traction on the joint partner near the body (proximal) and the one far away from the body (distal). The cartilage can thus be relieved. Cartilage is nourished by the alternation of pressure and traction.

The traction treatment can therefore also improve the nutritional situation of the cartilage and somewhat prevent further degradation of the joint cartilage. In addition, means of physical therapy can be used (heat, cold, electrotherapy). Splints and orthoses can relieve and immobilize the joint.

Tape bandages can also be applied by the therapist and protect the metatarsophalangeal joint of the big toe. Therapeutic insoles are often prescribed to buffer the toe in the shoe and facilitate rolling. Drug therapy with antiphlogistic painkillers should also be mentioned.

Creams and ointments can have a pain-relieving effect. Injection therapies are also used. Here, drugs such as preparations containing hyaluronan are injected directly into the joint.

Summary

Arthritis of the metatarsophalangeal joint of the big toe is the progressive wear and tear of the metatarsophalangeal joint of the big toe up to the complete loss of movement, accompanied by severe pain when rolling along the gait. Since we roll over the metatarsophalangeal joint of our big toe during physiological gait and this must therefore provide a certain degree of mobility, arthrosis of the metatarsophalangeal joint of the big toe can lead to a compensatory change in gait. In case of pain, a relieving posture can lead to a painful hamstring.

Changes in the gait pattern can put strain on other structures and joints, which can cause consequential damage. Have this analysed at an early stage with a gait analysis. The causes of the disease are not fully understood, presumably a mechanical overload or inflammatory processes in the joint promote the development of hallux rigidus.

Therapy is often conservative (physiotherapy for metatarsophalangeal joint arthritis of the metatarsophalangeal joint of the big toe, drug therapy, supports and orthoses). If the symptoms are too severe and resistant to therapy, surgery can be performed. If the symptoms are too strong and resistant to therapy, surgery can be performed to stiffen the joint.

Joint preserving surgical procedures are also possible. An endoprosthetic joint replacement is seldom considered. In physiotherapy and in the exercise program for metatarsophalangeal joint arthrosis of the big toe, the focus is on preserving joint mobility and relieving the joint and thus reducing pain.

The mobility of the metatarsophalangeal joint of the big toe should be trained by mobilizing foot gymnastics. The arches of the foot should also be strengthened and invigorated in order to enable a physiological gait pattern that is as gentle as possible. In existing relieving postures and limping mechanisms, the surrounding joints should also be included in the therapy/exercise program.

In manual therapy, traction treatment is the method of choice. In addition, physical therapy (heat, cold), orthoses, insoles and bandages, medication and injection therapy can be used. The patient should make sure to wear suitable footwear.