Hallux rigidus is a condition in which the metatarsophalangeal joint of the big toe becomes stiff. This is usually caused by degenerative diseases of the joint, such as arthrosis. This is a decrease in the joint cartilage mass and quality. Abrasion products cause frequent inflammation of the joint, in which the joint surface changes visibly and loses its resilience and mobility. In the most severe cases, the joint stiffens due to deformation of the joint surfaces and degeneration of the surrounding soft tissue structures.
6 simple exercises to imitate
1. exercise “traction” 2. exercise “rolling” 3. exercise “stretching transverse arch” 4. exercise “stretching back of foot” 5. exercise “massage exercise – big toe” 6. exercise “massage exercise – toe muscles “In order to keep the metatarsophalangeal joint of the big toe flexible in hallux and to prevent stiffening, light mobilization exercises can be performed. In doing so, care should always be taken to train the joint only in the pain-free area, as otherwise the overloading of the altered structures can easily trigger new inflammation. 1st ExerciseThe patient can mobilize his or her toe independently with the hands.
To do this, he should grip close to the joint, i.e. just below the joint with one hand and just above the joint with the other. It is advisable to grasp the big toe with one hand and place the thumb just above the joint. The metatarsal bone of the big toe can be fixed with the lower hand.
Now you can easily pull the joint surfaces apart. This is called traction treatment. The traction causes the painfully changed joint surfaces to be released from each other minimally.
Under this light traction, the toe can now be moved up and down. The movement should fall slightly and not hurt. You can do many repetitions of this mobilization as long as no pain occurs.
2nd ExerciseAfterwards you can also roll your foot over a ball to mobilize the arch of the foot and thus take the load off the toe. A tennis ball is particularly suitable because it is quite hard and can be used to stretch the tendon plate in the arch of the foot. The foot is placed on the ball while sitting or standing and rolled forward and backward with slight pressure.
The exercise should be repeated about 20-30 times. 3rd ExercisePractical exercises can also be gripping exercises with the toe in a warm or cold medium. Here the patient should look for himself what is good for him.
In case of an acute inflammation heat should be avoided. A bowl of warm sand or, for example, cooled peas is recommended. In the case of hallux rigidus, stretching exercises are more suitable for structures that are either involved in the development, i.e. put more strain on the metatarsophalangeal joint than necessary, or that tend to shorten more due to the relieving posture.
1. exerciseStretching exercises for the arch of the foot can have a relieving effect on the hallux rigidus. Besides rolling out the arch of the foot with a ball (see above), the arch can also be stretched with the hands. To do this, place your fingertips right and left around the foot in the longitudinal arch and place your thumbs on the back of the foot.
Now you can press the sides of the foot down and stroke the arch with your fingers. This stretches the tendon plate and mobilizes the metatarsal bones. 2nd ExerciseThe stretching of the back of the foot is also pleasant.
The toes are grasped flat and stretched slightly downwards towards the arch of the foot. Hold the position for about 10-20 seconds, release it and take it again. You should feel a slight pull in the back of the foot.
Stretching exercises for structures that are shortened by a gentle posture due to the hallux rigidus should be coordinated directly with the patient by the therapist. Since the evasion mechanisms can be versatile, it is difficult to make generalized statements. 1st ExerciseFor strengthening exercises in hallux rigidus, gripping exercises with the toe are particularly useful.
The big toe can grip around a pin and should hold it while you try to pull the pin away or push it in a certain direction. In this way, different muscle groups can be addressed. The pin should be slightly thicker so that the toe can grip it well.
The tension can be held for about 10-20 seconds in each direction. Approx. 15 repetitions are to be performed.
2nd ExerciseIt is also important in the case of hallux rigidus to strengthen the abduction of the toe.In the course of degeneration, joint malpositions often occur in which the toe deviates inwards (valgus position). This is an additional strain on the joint. By strengthening the abduction, one can try to prevent this deviation.
For this purpose, a tactile resistance can be given on the outside of the toe just above the base joint. Now try to spread the toe to the side, and only to the side. One likes to deviate upwards in the extension or downwards in the flexion, but this should be avoided in order to strengthen only the abductors.
The movement is very difficult in the beginning, if you have not yet performed the movement often. However, the extent of the movement is at first negligible and can be increased later, when the responsiveness of the muscles is improved. First of all, it is more important to activate the right muscle group.
Coordination exercises are rather not on the agenda in the treatment of hallux rigidus. The responsiveness of the abductors, which is described here as a strengthening exercise, certainly presents a coordination challenge at first. In the case of advanced stiffening of the joint, gait training may also fall within the scope of coordination training.
The physiological gait with as few evasion and protection mechanisms as possible should prevent overstraining other joints and enable walking as painlessly as possible. The treadmill ergometer and the gait school in front of a mirror are ideal for this purpose. Here, however, the patient should be controlled and supervised by a therapist.
Our feet carry our body weight all day long and if they do not hurt, we often pay little attention to them. But especially when pain and inflammation occur in the foot, massages can be pleasant. 1st ExerciseWith Hallux rigidus the metatarsophalangeal joint of the big toe can be treated by light strokes.
To do this, you stroke the joint with your thumb with light pressure. You should not stay in one place for too long and not exert too much pressure in order not to additionally irritate the bony structures. 2nd exerciseThe arches can be stretched and massaged as described above.
The muscles between the toes also tend to tense and can be loosened by circular movements with gentle pressure. In the case of acute inflammation, the joint should not be massaged or only very gently, as otherwise there will be increased irritation. If severe swellings are found in the big toe, massage grips from the lymphatic drainage area can be helpful in decongestion of the joint. The massage should always be performed from the tip of the toe to the foot.
