For runners experiencing pain in the joint of a big toe, the likely cause is hallux rigidus. A type of osteoarthritis, this injury can momentarily stop a runner’s training regimen or, in serious circumstances, can indicate a permanent end to running. Recognizing this problem early will play an essential function in getting early treatment and a gradual go back to the track.
Hallux rigidus is a type of arthritis caused by a wearing away of the cartilage that rests between the proximal phalanx bone, at the base of the huge toe, and the first metatarsal bone of the forefoot. Each time the foot is bent, friction is caused between these two bones, slowly decreasing the toe’s variety of movement. This condition normally establishes between the ages of 30 and 60, nevertheless, it’s unknown why some professional athletes establish the condition and others don’t.
Causes of Big Toe Pain After Running
Hallux rigidus amongst runners begins with biomechanics of the foot. Runners who are flat footed or overpronate are most susceptible. Pronation describes lateral movement of the foot from the point at which the heel strikes the ground to toe off during each stride. Overpronation is typically specified as a roll inward of 15 percent. Overtraining is likewise thought about a cause of hallux rigidus. Other causes include merely stubbing the toe, gout or structural oddities in the bone structure of the foot. Genes might also play a role in the start of hallux rigidus.
Sesamoids
Two small bones under the ball (head) of the first metatarsal are called the sesamoids. These bones remain in the flexor tendon to the big toe and act as fulcrums for flexing the toe; they are weight bearing structures. Runners may experience a number of sesamoid problems.
Inflammation of one or both sesamoids is known as sesamoiditis; increasing mileage, doing speed work and hill repeats, and bad shoes may all contribute to this issue. The affected sesamoid will be really tender to touch and pain might happen when the huge toe is bent upward. Swelling may exist under the first joint. Treatment consists of application of ice to the area, anti-inflammatory medications and protective padding (dancer’s pad) that is eliminated at the tender area, removing pressure on the sesamoids. If this relieves pain, simple running may continue. Sesamoiditis normally fixes in two to 4 weeks. If there is pain with pushing off, cross training must be performed to avoid an abnormal gait and the myriad of injuries that it may cause. On event, immobilization might be essential to remove sesamoiditis.
Sesamoid pain may be due to a stress fracture of among the bones. A bone scan is often needed to identify this injury. It is not unusual for among the sesamoids to naturally be in two pieces (bipartite); this does not cause pain, but may create a diagnostic challenge if a sesamoid fracture is suspected. Treatment is similar to sesamoiditis, though impact activities need to be reduced. The sesamoids have a poor blood supply, so stress fractures might take several months or longer to heal. On event, there is persistent pain; as a last option, the affected sesamoid might be surgically excised.
Bunions
A bunion is a lump on the inside of the first toe joint due to an unusual positioning of the joint. The first metatarsal points inward and the big toe points toward the other toes. In addition to the bony defect, the soft tissues over the lump may swell, making the lump bigger. As the huge toe relocations external, it puts pressure on the other toes, and in severe cases may move under the second toe.
Running does not cause bunions, however a bunion may produce problems for a runner. Bunions are not constantly painful and symptoms are typically managed by wearing a shoe with a wide enough toe box to accommodate the defect. A spacer in between the first and second toes may be helpful; a bunion pad used directly over the bump may reduce pain. An orthotic might provide relief of symptoms due to the change in the alignment of the joint. Properly fitted shoes should be used at all times, not simply while running. If pain ends up being severe enough to limit activities, surgery might be required. Usually limited cross training might be begun numerous weeks following surgery; running may be started two to three months following the surgery, depending upon the procedure performed and the course of recovery.
Hallux Limitus
Hallux limitus is limited movement of the first toe joint. This is normally due to arthritis from previous trauma (turf toe, and so on) or a condition such as gout; a bone spur may be present on the top of the joint. Pain occurs with activities that need substantial upward flexion of the big toe. Initially, ice, anti-inflammatory medications and a shoe insert with a stiff portion at the first joint might be helpful in controlling symptoms. Working on variety of movement of the joint might help preserve movement for a while, according to iytmed.com. Surgery to eliminate the spur on the top of the joint may lead to improvement in movement. As the arthritis progresses in time, hallux rigidus establishes. The same treatment procedures should continue. Running becomes difficult due to an abnormal toe-off. A cortisone injection in the joint may help decrease the pain briefly. A stiff orthotic might allow continued running. If the pain ends up being too severe, surgery may be needed.
Gout
Gout is a metabolic condition where uric acid crystals accumulate in a joint due to overproduction or undersecretion of uric acid. An attack is frequently related to intake of a rich, fatty meal and alcohol. The first toe joint is the most frequently affected joint. Throughout several hours, the joint will become red, swollen and exquisitely tender. Goal of fluid from the joint will expose uric acid crystals, confirming the diagnosis and dismissing an infection, which is comparable in look. Anti-inflammatory medications are used to treat an intense episode of gout. Symptoms should enhance over several days. Reoccurring episodes of gout may cause substantial damage to a joint and need using chronic medications.
In amount, the huge toe is a huge deal. This fairly small joint allows us to run freely. It deals with a large amount of stress with ease up until a problem establishes; then it can end up being an incapacitating problem. Make certain that your shoes fit well and keep them in excellent repair to lower your risk for huge toe problems.
Symptoms
In its early stages the condition is often referred to as hallux limitus. Symptoms might appear as limited movement of the joint at the base of the big toe or big toe bone pain after running. Tightness of the joint while moving, pain on top of the toe and mild swelling are frequently experienced. As the injury progresses, symptoms end up being more serious and include pain, even at rest; hopping; bone stimulates; and pain in other areas of the body, such as the knees and hips, as the affected individual adapts to make up for the pain.
Treatment for Big Toe Sore
Treatment of hallux rigidus normally begins with footwear. Wearing shoes that have a larger toe box decreases pressure and friction on the base of the toe. Stiff-soled shoes are also suggested. Other options for nonsurgical treatment include nonsteroidal anti-inflammatory drugs, physical therapy, orthotic inserts and coricosteroid injections for pain and swelling.
Surgical Treatment
In severe cases, surgery might be needed to minimize big toe sore after running. Surgical treatments for hallux rigidus differ depending upon the damage in the joint. Many x-rays are normally necessary to supply the physician with a comprehensive photo of the intensity of the arthritis. Sometimes, more than one surgery might be required. A patient’s activity level and age may likewise contribute in identifying the best surgical treatment for hallux rigidus.
