Hallux limitus in the athlete

Hallux limitus is one of the more common conditions occurring around the great toe, characterized by a progressive decrease in the dorsiflexion range of motion at the first metatarsophalangeal joint. Bony proliferation and articular degeneration of the joint result in pain and possible disability. Any force or condition which results in the restriction of dorsiflexion at the 1st metatarsophalangeal joint may, over time, produce typical changes around the metatarsophalangeal joint including the formation of dorsal exostosis, marginal osteophytes, erosion of articular cartilage and possible ankylosis. All of these changes are capable of producing pain in and around the joint. In summary, the condition is characterized by bony adaptations around the joint (hypertrophic spurring/ osteophytes, etc.) and eventual degeneration and destruction of the articular cartilage of the joint, possibly resulting in ankylosis. This article will review the biomechanical influences which may lead to hallux limitus/hallux rigidus, the clinical evaluation of the condition and suggestions for subsequent treatment.