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Friday, March 23, 2018

Hallux Rigidus: Avoid Aggressive Mobilization



Dear Dr. Blake

I wrote to you last August re my hallux rigidus in my right toe which flared up after a physiotherapist manipulated aggressively. 

I am now on orthotics after seeing a podiatrist in Hong Kong. The pain has lessened but I still can't do the Latin ballroom dancing which I love. I am so depressed. Now my only exercises are walking, stationary bicycling, pilates, etc. I have been dancing for over 20 years. 
I am even afraid to dance aerobics in the gym.

My podiatrist says the toe should fuse naturally but no one knows how long that would take. I don't want surgery either because of the unknown.

The toe still hurts on a daily basis. I used to just feel a bit of pain after wearing high heels but after that physiotherapist messed this toe up its constant unpredictable pain.
Any advice would be appreciated.
Attach the latest x-ray of my foot.
Regards

 Marked joint degenerative disease 

This oblique view actually shows the joint is a long way from fusing. Only a small amount is bone to bone.

Dr. Blake's comment: I am so sorry, and I wish I could predict how fast this will calm down. I have attached my original article on Hallux Limitus/Rigidus to emphasize to treat it as a sore joint and boot it at least 4 hours per day to get complete rest. You can have a physio use EGS with ice to calm the joint down for 6 visits--no manipulation, please. The joint is too open to expect fusion in the next 10 years, but 3 months in a boot may do the trick. I would also spica tape it every day to immobilize also. Your bone health looks good in the photos. 

Here is the link to my early comments on this subject. 

2 comments:

  1. Dr Blake you think I should consider surgery in order to go back.to dancing

    ReplyDelete
  2. There is a good chance if this does not calm down. I believe you are a good candidate for joint replacement in which you can dance with, but I am not a surgeon. I would see several surgeons now, so if 3-6 months it does not calm down, you already have chosen the surgeon. Good Luck. Rich

    ReplyDelete

Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.