Total Pageviews



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.

 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. 


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

  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


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.