Hallux Rigidus

hi I've recently been diagnosed with Hallux Rigidus (Big Toe Osteo Arthritis) in both my big toes. I am a 38 year old female, who has completed a Marathon and many other distances in the past. At the moment I can remain active by cycling/spinning but running is inadvisable. I went to the consultant yesterday and was told the condition will just get worse as I get older. At this time, whilst I suffer some pain in my toes it isnt crippling and is significantly worse in winter. He gave me 3 options:

1/Buy MBT shoes or rocker sole type shoes (Ive bought some Clarks)
2/Steroid Injections
3/Surgery to fuse the joint

For now Ive decided just to go down the shoe route, but I'm keeping my options open re 2 and 3. Is there anyone out there who either has some expert advice or someone who is/has suffered with this? Would be a massive help!!


  • Hi, I'm 5 weeks post op for a right big toe fusion due to hallux rigidus.  I tried to ignore it for a long time but eventually I had stress fractures, hip bursa, torn tendons, knee out of alignment and pain in both big toes at night, driving, walking and found it impossible to wear shoes with any type of heel - both big toes were both completely fused with arthritis.  My biggest bit of advice I can give you is to limit your activity!!!

    I had steriod injections at first - painful, but they work for a while, I tried orthotics over the years and had 3x3 week intensive live in physio.

    Post op it is still really, really painful.  I have been told I cannot run again but hope to at least do some Hash House Harriers activity even if it means walking at the back.  This has been life altering for me and I don't know what my future now holds.

    I think that it is best to delay the surgery for as long as possible as afterwards there is no going back and although you will no longer have joint pain you will have a disfunctioning foot. 

  • Thanks doesnt sound overly positive> both my big toes are riddled with pain! I dont particulary want to limit activity but I am switching to cycling over running!  Next step injections I think. Have good and bad days. Have been limping at times! Good luck nwith yours !
  • Really sounds awful for you both.  Fortunately I don't have such problems but I used to run with a lady who was riddled with osteoarthritis, she swore that it was only the running that stopped her from siezing up completely and that the continued movement was better than any other treatment she'd had.  She did take meds to control the pain as much as possible but she ran right up to marathon distance and was still running way into her 70's.

    Sincerely hope you both find a solution that works for you.

  • Thanks Sunluvva, as Im only 39 I dont want to seize up, but I have concerns re the long term damage I could be doing to my other joints from continuing to run.... I've booked an appointment for the cortazone injections so i'll see how that goes.

    As I said it affecting the way I walk. Worse in cold , damp weather, sniff!

  • I went for my x ray today and the toe hasn't fused.  I wondered why it still hurt so much.  I've got to go back in 4 weeks and also have physio as I'm walking badly on the outside of my foot ,causing the rest of my bones to deform.  I don't think I'll be walking for a while now image.

     Nickers I'm only 34 and honestly, my advice is to stop running, I do wonder that if I had listened to my consultant before I may not be in this situation now.

  • I think you a right to avoid surgery if possible. try talking to an orthotist who may be able to give you some alternative advice re footwear, maybe custom orthotics to off laod the weight.
  • My brother had surgery on both his toes after suffering really badly, this was done some 20 years ago (he was in his 20s so is now in his 40s). He is running more than ever before without any problems. To be honest I have never heard him complain about the toes since the surgery, and my brother loves to complain.

    Hallux Rigidis surgery or no surgery doesn't need to be the end of running, but of course not all are treated successfully unfortunately.

    Just thought we needed a positive story here too.

  • thanks Zaba,  I needed a positive slant on things today.  Mind you I woke up positive today and it feels much better. 

    My problem is not getting things done early enough so I caused so much more damage to all my other joints from my poor gait.  I also ran much too much, much too young (sounds like Bad Manners huh?).

  • Hi Guys,  thought I'd update you on this.  I'm now 4 weeks post op from further surgery.  This time they've pinned and plated the toe, they were going to hip graft it but thought they'd just make it a lot shorter instead.  They were also going to cut my acheles tendons as they have shortened considerably but then decided I could have lots of physio post op instead.

    I'm now really, really fed up but hopefully, there is light at the end of the tunnel image

  • Hi marns. When u say activity is limited. Do u mean running is out but u can cycle and stuff?

    I've just posted about something very similar. Was hoping to do triathlons instead but by running I seem to have just escalated the problem. I'm considering bunion surgery but after that it would b fusion. I'm 35! I'm a runner! So it's life changing for me too so I can really empathise. I think I do hav to accept running might be out but I need to know that with a fusion as the extreme that I will be able to hike in lakes and cycle competitively. I hav to replace running with something. Any advice.
  • hi , i suffrered for a long time with this when i was a ballet dancer. the pointe work for hours on end during performance caused it and like you say in cold weather it was so bad i couldnt bend or flex my toes .

    i saw a gp who initially recommended ibuprofen and physio . this worked initially but would still be there on and off. mine diappeared when the warm weather appeared image to this day i get problems in cold weather . i find wearing flat shoes makes it worse so its now an excuse to buy and wear more stillettos-doctors ordersimage

    maybe yes tryimn g diffeerent trainers or inserts would help though

  • Hi all,

     I'm 40 and have had this for a couple of years now. I'm still running but it is a worry that it will just get worse and worse with age. I take glucosamine, CMO and cod liver oil which helps but there is still some pain.  I've just read glucosamine with chondroitin  helps as well.

     All this talk of surgery and cortizone injections doesn't sound too good. I hope you're all OK, does anyone have any other tips?


  • Hi

    My first comment is to avoid surgery if you can. If glucosamine/cod liver oil work - take it.

    See an Orthotist, not a Podiatrist, not just a Physio, although a physio may be able to provide additional help. An Orthotist is qualified to make you made to measure foot orthoticts to relieve some of the pain. He/she will also look at your feet in relation to the rest of your body which a podiatrist will not necessarily do. Orthotics is about keeping the body in good alignment.

    O/A is not going to go away, but well made orthotics can releve some of the pressure on your feet & so relieve some of the pain as may rocker soled shoes. Find what works for you. Put Orthotist into Google & see who comes up in your area. Check they are registered with HPC, The Health Professionals Council before you book an appointment.

    Good Luck!

  • Hi all resurrecting. An old thread as I am 7 days post fusion op today ! So still in foot above heart taking it easy mode . Stitches out on Friday and hopefully walking boot or similar . My surgeon seems pretty confident that I will be able to run after full recovery but I have read some pretty negative stuff regarding this on various sites and forums . I have been planning some epic mountain bike rides just in case (starting with the SDW later this year ) . I had to give up my place in the VLM as I obviously shan't be up to a marathon even if I am able to run . Devesatated though as was really looking forward to the training pushing on over Xmas ( had just gone over 10 miles on my long runs which felt fantastic image oh well

    Fingers crossed ps I'm 43
  • Hey all, I know this thread is old but I am in my late 20's and am looking at getting a fusion. It would mean a lot to me if anyone could let me know if they've had success with their fusion, and if they can run again! If you can run, can you tell me mileage and if you're in pain. If not, can you describe the level of activity you have now? If I want my quality of life to improve I will have to get this done sooner than later. I can already feel my other joints starting to hurt and I believe it's because of this bad foot.

  • (Hi I'm a newbie on the forum and hijacking this similar old post as it seems I can't create a new one).

    I had Hallux rigidus, and gave up running 2017 as a result. I ended up getting a 1st metatarsal joint fusion in December 2019.

    I'm looking for advise on off road shoes on the market that might suit the advice I've just had from a podiatrist. So I can seek them out and look at 1st hand.

    Ultimately after a 1st MTJF you may have removed the pain ..but you end up with deformed foot and balance/gait issue. Happily my podiatrist has advised to suck it and see starting on the flat and in my Hoka Bondi's with short distances and slowly work up distance and if that goes ok and I want to try some off road (which I really would like to) look for the best shoes available that provide, both plenty of cushioning at the ball of the foot/toes, but also which are pretty stiff so will reduce toe flex and stiff laterally across the ball of the foot.

    Obviously off road, chunky soles can become a bit of a trip/ankle twisting hazard so I can't see that my current road Hoka's will be good for anything other than FC type tracks on moderate slopes. So suggestions on possible off road shoe candidates much appreciated so I can create a short list to seek out and investigate.

    Thank you
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