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Thursday, September 30, 2010

Hallux Rigidus Spica Taping: Also For Bunions, Hallux Limitus, Turf Toe



     The above video demonstrates a simple, but effective, taping to limit motion in the big toe joint (first metatarsal-phalangeal joint). Kinesio Tape is used 1" in width and 8 inches long. For painful problems like turf toe, Hallux Rigidus, Hallux Limitus, sesamoiditis/fractures, and bunions this taping can prove helpful. I look at it as I would an ankle brace for a sprain. There are various versions that can be tried, but the most common technique is demonstrated.

12 comments:

  1. Wow!
    This is so amazing. I like you're experience. I am happy reach at this site.

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  2. This post was very nicely written, and it also contains a lot of useful facts. I appreciated your professional way of writing the post. You have made it easy for me to understand.

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  3. There are various versions that can be tried, but the most common technique is demonstrated. And you need to do that.
    View news

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  4. Thanks for the informatiĆ³n.
    If we make the tape by dorsal foot,increasing dorsiflexion 1st finger, would improve the MTTF 1 ROM?
    is contraindicated? You know if the technique is described?
    Thanks

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    Replies
    1. Thanks for the comment. If you tape to pull the big toe up, it may run into the top of the shoe causing pain. That being said, if you tape in neutral the way you described, it may work to assist pulling the toe up, and thus, if done gradually, could overtime increase the good dorsiflexion motion. I will definitely have some of my patients try. Thank you for thinking outside the box. Rich Blake

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  5. Hi, I fractured the head of my 1st metatarsal about 8 months ago and wore a CAM boot for about 2 months. Since then I have tried to limit my activity but continue to experience intermittent pain just below my big toe on the top, side and bottom. It is not unbearable, but can be a nuasance. I would like to try taping it to better stabilize it in hopes it will continue to heal. Would this be a good taping style? Or is there something else you would recommend?

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  6. This is an appropriate taping for your injury. If you can, get an MRI to look at the amount of bone and soft tissue swelling that still is occurring. If alot, daily icing and contrast bathes for the next 4 months may be appropriate. Good Luck!!

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  7. Hi Dr. Blake,
    I have a sesamoid fracture and have just stopped wearing a cam walking boot after 4.5 months. After the fist 2 months I had an MRI which showed bone edema and definite medial sesamoid fracture. At that point I started doing all of your recommendation,ie spica taping, ice, contrast baths, calcium and D as well as strict non weight bearing. Xray at 4.5 months did not show the bone healing but also did not show any further separation of the sesamoid fracture and pain essentially resolved.
    Ok so my question is
    #1 I started PT three days ago and the physical therapist, Who seems very knowledgeable and caring, said i should have not spica taped so long and forced the dorsiflexion of my great toe causing pain. I objected in fear but he insisted it was not going to hurt my situation and the proper thing to do. I have had some mild discomfort since then. Also the exercises he gave me focus on lengthening the achileis and ROM for great toe dorsi-flexion. Should I resist this treatment?

    #2 He also wants to start ultrasound today stating it will help to increase the healing of my sesamoids or at least improve the scar tissue in between the two pieces. Ive read in your post its contraindicated? Also As a primary care provider, Im familiar with having my patients use ultrasound to break up scar tissue in painful areas.

    After two days of returning to my ice bone stimulater and contrast baths pain has subside but not sure how to proceed.
    Thanks for any thoughts and i think its wonderful you are providing the site.
    Thanks
    Dr. Scott Credit

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    Replies
    1. Dear Scott, thanks for the email. I definitely do not recommend ultrasound until I am 100% convinced the bone is completely healed. Sounds like he is aggressively treating the big toe version of "frozen shoulder syndrome." When you see him again, have him measure big toe joint dorsiflexion and plantarflexion on both sides and send to me to give me perspective. I typically start the Self Mobilization you will see in my Hallux Limitus posts and allow weight bearing to gradually increase the range of motion. Calf stretches are great. The goal through Jan 1st (today is November 15th) is to successful wean out of the boot into shoes, orthotics with dancer's pads, spica taping, and begin daily foot strengthening, calf stretches, joint mobilization, and anti-inflammatory (as you are bound to aggravate the area at times). Hope this helps you. Rich

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  8. i have hallux rigidus and am looking for some way that i can continue to swim. Is this tape waterproof? would it suit my purposes at all?

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    Replies
    1. Please try 3M Nexcare Waterproof Tape for the spica taping. It is alittle more rigid, so takes longer to learn the technique. Rich

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  9. dr Blake - I had cheilectomy an yr ago. Since then, I’ve had heel pain/plantar twice - it healed after 3-4 months 1st time. Now, for the last 4 months including Achilles tendinitis. I’m doing pt.. how can I resolve the condition and is there a connection between cheilectomy and frequent heel pain? Thanks.

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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.