From the Research
Treatment for functional hallux limitus should prioritize custom foot orthotics with added support under the first metatarsophalangeal joint, as they have been proven to improve joint mobility and reduce pain, as shown in a 2016 study 1. The primary goal of treatment is to improve first metatarsophalangeal joint mobility and reduce pain. Custom foot orthotics with a first ray cutout, kinetic wedge, or Morton's extension are effective in controlling excessive pronation and providing proper foot alignment during gait.
- Key features of orthotics for functional hallux limitus include:
- Added support under the first metatarsophalangeal joint
- First ray cutout
- Kinetic wedge
- Morton's extension
- Physical therapy is also beneficial, focusing on:
- Joint mobilization techniques
- Stretching exercises for the plantar fascia and calf muscles
- Strengthening of intrinsic foot muscles
- Footwear modifications are essential, with recommendations for shoes that have:
- Adequate toe box width
- Rigid soles to reduce forefoot bending
- Rocker bottom designs to decrease joint stress during push-off A 2020 study 2 highlights the importance of shoe modifications and foot orthoses in treating patients with hallux rigidus, which can also be applied to functional hallux limitus.
- Pain management options include:
- Over-the-counter NSAIDs like ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily) for short periods
- Corticosteroid injections for temporary relief in more severe cases Conservative measures should be tried for at least 3-6 months before considering surgical interventions such as cheilectomy or joint decompression procedures, as suggested by a 2004 study 3. The condition results from functional limitation of dorsiflexion during gait despite normal range of motion when non-weight bearing, often due to first ray hypermobility or abnormal foot mechanics, making biomechanical corrections through orthotics particularly effective, as noted in a 2003 study 4.