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BIG Toe Pain!! RELIEF & Walk Normal Again (Hallux Rigidus)
- chelsie462
- Sep 30
- 9 min read
This article is a transcribed, edited summary of a video Bob and Brad recorded in August 2024. For the original video, go to https://youtu.be/JSi0XvL-OMk
Brad: Oh, wow, this big toe pain is really making me limp. Boy, does it ever hurt.
Mike: So today we are going to be discussing the best treatment options for big toe pain, addressing subjects like gout, bunions, arthritis, and sesamoiditis.
Brad: That's right, I was going to say arthritis, also known as Hallux rigidus, which means your big toe is stiff. I want to get into the acute phase, actually, when that toe is red and inflamed, and it came on for no apparent reason. Sometimes that can be gout. Now, if you suspect you have gout, you should go to a doctor, have it evaluated, and make sure it's diagnosed properly so you get the proper medication. You can, however, treat it with simple things like an NSAID, for example.
Mike: Tylenol or Ibuprofen.
Brad: Whatever works best for you. Also, elevate the foot if you have swelling in there. So, in your chair, make sure you have pillows underneath it so it's higher than your heart. This helps the fluid come downward. Also, make sure you drink plenty of water.
Mike: Also, it's important to avoid inflammatory foods. Everyone reacts differently to different food groups, but typically, if you're having tons of salt and sugar, you want to cut back on those things.
Brad: That's right. Now, the footwear that you're using, regardless of what the diagnosis is, whether it's gout, arthritis, or anything, it's very imperative that your feet, the forefoot, and the toes are not squished in. Mike, do you want to talk about some real basics of proper footwear?
Mike: So if you look here, this is a normal, typical shoe. This is a shoe with a wide toe box, and it's typically called zero drop.
Mike: That just means the amount off the ground your heel and your forefoot are the exact same. You could see the narrowing of the toe box here. This can cause a lot of issues with great toe pain, including bunions, sesamoiditis, and a whole lot of other issues. So getting better footwear can allow your foot to return to more of a natural foot shape. Like my monkey feet here.
Brad: Yeah, you've got a beautiful foot there. The zero-drop part he's talking about really is not the important part, but it is that you have the wide toe box. If you look at these, these are both wide toe boxes, which means it's not squishing or pushing your toes in together.
Brad: But for most cases, you're probably going to want to have a cushioned sole. This one is not cushioned. If I do the one finger test, in other words, to see how flexible the sole is, very easy. The one with a cushion, more rigidity, and it offers support on that great toe, and we'll talk about why that's important a little bit, the cushion as well.
Mike: So now we want to get into sesamoiditis. It's a big fancy term for basically saying you have pain right here.
Mike: This is your first MTP, or metatarsal phalangeal joint, basically where your toe connects to your foot. Now this area can get problematic for people who run a lot, dancers, and people who are on their forefoot quite often. So what are some options to help relieve this pain?
Brad: Actually, the cushion, just get the wide toe box with the cushion throughout, and that's going to be helpful. Now, the other thing is simply to use common sense. If your toe is flared up from whatever diagnosis, you need to stay off of it when it's very tender. In other words, hiking, walking, particularly on uneven surfaces, can really irritate it. Basic common sense: listen to your body. Now, let's get into that chronic pain where your toe's been bothering you, but you can still use it for long periods of time. Range of motion, or actually stretching the toe out, can be very helpful. However, if you have not done any range of motion or stretching specifically on the great, or the big toe, do it gently the first time. You could flare it up and make it sore, and you might say bad things about me. So we would not want to have that. Take these gently. After the first day, you might want to wait a day and go after it again the next day, and then work on it daily, or even more than once a day as you get going. We're going to talk about the first, the great toe only has two joints in it. This one, the one that we call the first MTP joint, don't worry about what that acronym is for. That joint is usually the one that causes the most problems. We're going to get after that, though, the most aggressively, but we need to work on ranging the toe out. Now Mike's going to do it in a figure four position. Works very well. I'm going to do it off a chair, which also works well. Do whatever works best for you. And now I'm going to actually show my foot.
Mike: Oh my goodness.
Brad: I just cut my toenails, so things are looking very good. I wanted to make sure that was clear. All right, so first we're going to work on the range of motion of extension and flexion, just a general range. It's a good way to start. All you need to know is two fingers. Mike, just pop in when you have something to say that works well for you or people you have worked with.
Mike: Just gently do it, push down and go up. Obviously, if you have arthritis in there, it's probably going to take a few repetitions to warm up. You can aim for 10 reps, you can go up to 30 reps, whatever feels comfortable for you, and let's go into the next motion.
Brad: Yeah, mine's already starting to crack and pop a little bit; it's loosening up. Now, if you want to get a little more aggressive, and some of you will need to do this, or want to after you've done it for a few days, you can actually pull up and get that extension, which is going up. That is important for when you walk on this heel part of the gait, which we won't get into, but this is what happens to the toe. And then also make sure you go down and push. You can see I'm working both joints fairly aggressively. When I put this joint right on the edge of this stool, it works there. And I could go here and just isolate that joint. Again, that one, the farthest one by your toenail, is not really needed so much.
Brad: Work that, and then the next direction is going sideways. Now this can be really helpful, particularly if you have bunions, because the toe gets pushed in because of our footwear, particularly with pointed footwear with high heels that really squish those toes together. Mike's doing a real nice job. Go ahead, Mike, talk about it.
Mike: You tend to get some leverage if you push down roughly where your bunion area would be. So I'm keeping my thumb there. Oftentimes, if you have a bunion, your toes are squished like this. So just do what's comfortable. Obviously, I have a little bit more range of motion, but even I feel a stretch right there if I start pulling out. So just kind of pull out, hold for a few seconds. You can kind of range going in and out. You're just going to feel a good stretch in there, and I'm actually enjoying this right now.
Brad: Well, good for you, Mike. And he's only like 35 or something like that. Wait till you get to be 60. Now you can take a gauze roll. This is a really good static way, in other words, a passive way to stretch the great toe. This is, I actually have some Coband which works really well, but a gauze roll works good, and you simply put it between your toes like this. There you go, can you see that?
Mike: Get a good stretch.
Brad: Yeah, it feels good. Now, the thing you do with it, you just leave it in there for maybe a half hour or whatever is tolerated. You can actually walk around barefoot with this, and it'll stay in as long as you have the right size. Really good idea, stretch the toe out. You can actually put it through some of your other toes if you want, but we're talking about the big daddy, great toe, that's all we're going to address. Mike, what else did we forget? Anything?
Mike: They do make toe spacers if you want to have a product that actually fits in between all your toes. Some are made for sitting, some are walking. You can check them out as an option. But there's another thing we want to talk about is actually kind of distracting the toe a little bit, or pulling it up, and you can add a little bit of a rotational component to it. Obviously, it's not as mobile as your hip joint, which is actually a ball and socket, but you just kind of pull up, get a little distraction, and then do a little rotation. That might work for some people.
Brad: Now, the last stretch I want to show is what we call mobilization in the therapy world. This is a little more aggressive. You do need to have like a solid edge, like on this stool. And if I'm gonna mobilize the first joint that we talked about here, we put that joint on the edge, and I'm going to stabilize the bone in this area so it doesn't move. Grab the bone on the other side of the joint, and I'm going to move it up and down. If we can get a close-up of that, I'm going to pull up and down. There will not be a great deal of movement there for most people, but you are actually mobilizing the joint specifically. It can be a good way to work on it. If you want to do the next joint, you can, but it's harder to do that one, and then usually, oh, I've got some pretty good movement there. Look at that.
Mike: That's kind of hard to get that little one.
Brad: Yeah, it is. Well, if you have a round edge, that's a good example. Off the edge of a bed will not work very well. You need a firm edge there. Okay, good. So I think you'll want to go through these stretches. You'll find some work better than others depending on the needs of your big toe and what your diagnosis is. Again, all those stretches are good. If you've heard the diagnosis, Hallux Rigidus, hallux means big toe, rigidus means it's tight and needs some movement. Now, as far as a massage gun, really the only application for a great toe mobilization is on the bottom of the foot close to the first MTP joint, or right here where I'm demonstrating.
Brad: You're not going to massage the great toe at all. Just a little warning for that. Mike, what else? We got another video going on coming up?
Mike: If you want to check out more videos on big toe pain, specifically Sesamoiditis, where we get more in-depth on it, you can check out "Sesamoiditis-Home Remedies- What is It? (Pain at the base of Big Toe)."
Brad: Yeah, I like that word, sesamoiditis. "Itis' means inflammation, sesamoidea, see, we should educate our viewers on how these terms originated.
Mike: Yeah, just watch the other video, I'll tell you.
Brad: There you go. All right, enjoy, have a good toe, and have a good walk.
Mike: Have a great toe.
Brad: There you go.
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