Hallux rigidus can interfere with daily life, and if you’re a runner, it can make you feel like there’s no hope for enjoying running anymore.
The good news is that with careful treatment and management, you can keep running even though you have a stiff and sore big toe.
Here are our best tips for running with hallux rigidus.
What Is Hallux Rigidus?
Hallux rigidus is a common foot condition caused by a type of progressive arthritis that affects the base of the big toe.
This causes the toe joint to become painful, stiff, and progressively inflexible. As the condition progresses, you’ll find it increasingly harder to bend the toe until you’re no longer able to move it.
It’s essential to try and get an early diagnosis when the range of motion of the big toe is only somewhat limited or slightly stiff. This early stage is known as hallux limitus.
Not only can early detection help prevent the condition from getting worse, but you can take steps to help prevent you from changing your stride to compensate for the pain.
This will decrease your risk of lower back, hip, or knee pain. However, if the condition is already advanced and you’re finding it difficult to move the joint, everyday tasks requiring significant upward flexion of the big toe, like running, walking, and bending, are painful and challenging.
In some cases, you may develop a bone spur on top of the big toe joint, making it very difficult and painful to wear shoes.
What Happens to Your Big Toe When Running?
Your big toes play a critical role when you walk or run. They support up to 40 percent of your body weight with each step!
The big toe stabilizes the foot, supports the arch, absorbs shock, and provides propulsion. It also helps distribute impact evenly and transfers energy efficiently during the push-off phase.
This constant use of your big toe joint makes it more susceptible to developing osteoarthritis and overuse injuries.
So how does a stiff big toe affect your running?
You may find yourself changing your stride to try and get your foot off the floor effectively. However, this results in a “choppier” stride, where you become slower and have a less efficient running gait. This can lead to pain in other parts of the body.
Even though you’re trying to modify your running style to reduce pressure on the big toe, it doesn’t reduce or eliminate the impact force that’s placed on the foot when you’re running.
You’ll also find that you cannot move your ankle—limited ankle dorsiflexion—properly over your weight-bearing foot when your big toe is stiff.
This lack of movement can lead to a breakdown in your kinetic chain, which can cause:
- Early muscle fatigue
- Pain in both the calf and Achilles tendon
- Extremely tight calves or calf strains
- Plantar fasciitis
- Metatarsal stress fractures
- Knee, hip, and lower back pain
What Are Symptoms of Hallux Limitus and Rigidus?
The first symptom you’ll notice with hallux limitus is that your big toe feels stiff and uncomfortable, with pain on the top of your big toe joint that worsens with activity.
You may notice that the pain increases when you try to bend your toe or have trouble trying to flex it.
The pain, discomfort, and stiffness can increase. Cold, damp weather often aggravates it.
As the condition progresses, you’ll notice a significant loss of range of motion or you may not be able to move your big toe.
The pain will increase and be more noticeable when walking, standing, bending, or even resting your foot.
There will be swelling or inflammation around the joint, especially on the big toe joint, and you may also notice a bony lump on top of your big toe joint. This bony lump could be either a bone spur or a dorsal bunion.
Can You Run With Hallux Rigidus?
Yes, the good news is that you can still run if you have hallux rigidus!
The first step you need to take is to change your running shoes. The best shoes for hallux rigidus will have a stiff, supportive midfoot, a thicker outsole, and a rocker bottom.
A stiffer shoe will help limit the range of motion of the big toe joint, while the rocker bottom lets your foot “roll” into the push-off phase. This allows the movement to be absorbed by your shoe instead of your big toe joint.
If you feel like your shoe could be a bit firmer, you can look at adding a Morton’s extension insert to your shoe. It’s specifically designed to support and limit the motion of your big toe by slipping it under your insole.
You can also try taping your big toe before you head out for a run to help limit the toe’s range of motion. This will also help to alleviate the discomfort and pain in the joint.
Alternatively, you can use insoles for hallux rigidus that mold or conform to the shape of your foot to stabilize, support, and improve functionality while running.
Make sure that the shoe has a wide toe box so that your toes can splay naturally, as this will help reduce the load and pressure on your lesser toes.
With that said, you should consult with your doctor or podiatrist if your symptoms get worse, or if a stiff shoe or insole doesn’t alleviate the pain.
Your doctor may then recommend that you have surgery to help relieve the symptoms.
What Type of Surface Should You Run On?
Fortunately, runners have a variety of surfaces to run on, with each having a different impact on your joints and muscles.
While concrete and asphalt are often readily available for running, you may want to switch to running on softer surfaces like synthetic tracks, grass, dirt trails, or even a treadmill.
This will also help protect your joints and reduce the risk of injury if you are prone to injury from running on concrete or asphalt.
Most runners prefer the outdoors, but you may want to consider investing in a treadmill.
There are some great treadmills that come with cushioned belts, which help reduce impact forces while providing a challenging run.
You may want to run on dirt trails for long-distance running, as this will be more forgiving on your feet than running on concrete or asphalt.
How Can You Treat Hallux Rigidus After Running?
While you may not be able to prevent hallux rigidus, you can take steps to help slow down the progression and alleviate the symptoms.
Begin treating your feet immediately after a run, as this will help alleviate the symptoms of hallux rigidus.
Start by resting your feet as much as you can throughout your day. Recovery sandals like Oofos or Telic can help if you wear them post-run.
Apply cold or heat treatments using ice on the affected toe joint or taking a contrast bath. You can do this several times throughout the day, by placing your feet in warm water for 30 seconds and then straight into ice-cold water for 30 seconds.
Alternate between the cold and heat treatment for 5 minutes, as this will help alleviate pain and reduce swelling.
Include cross-training into your weekly routine. This will give your feet ample time to rest and heal between your runs.
You’ll also be maintaining your hard-earned fitness gains while strengthening muscles that you may not be using while running.
Look at including low-intensity workouts in your routine like swimming, rowing, or biking, that don’t place excessive loads on the toe joint.
To help manage the pain and reduce inflammation, you can use anti-inflammatory medications like ibuprofen.
However, you may want to speak to your doctor about a long-term treatment plan that will help you manage and alleviate the symptoms.
As part of your long-term treatment plan, your doctor may recommend the following:
If you’re in the early stages of hallux limitus, exercising your toe joint can help slow down the progression.
However, if you have limited toe mobility, these exercises can help you maintain the mobility and flexibility that you have in the joint. They can also help alleviate pain and delay surgery.
You would want to take your time with the exercises to work the muscles in your foot.
Your doctor may recommend physical therapy to help decrease the discomfort and alleviate the pain in your foot.
The physical therapist may use more than one treatment method to decrease the pain and discomfort in your foot.
The goal of these methods are to increase the range of motion of the big toe joint, and they may include:
- Interferential current
- Hands-on treatment like soft-tissue massage
- Gentle stretches and exercises
Taking a nutritional supplement like glucosamine-chondroitin sulfate may help relieve symptoms of osteoarthritis which can cause hallux rigidus.
If you’re experiencing severe pain and inflammation, your doctor may recommend cortisone injections.