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Monday, November 16, 2020

Hallux LImitus: Can I Avoid Orthotics?: Email Advice

Hello Dr. Blake, 
I came across your article  “ Treating a runner with Hallux Limitus who does not want to stop running.” while searching online for advice to keep running after being diagnosed with Hallux Limitus with bone spurs. 
Is it possible to keep running with this diagnosis without orthotics?     I run in Brooks Ghost and put in about 15 miles/ week. Can I run in my Brooks with the medium gel toe separator and avoid additional injury to the joint ? 

Any advice is greatly appreciated. 


Dr. Blake's Response:

Hallux limitus is a slow gradual progressive degenerative process when there are spurs. I have had runners for 30 plus years continue running, but there is no magic cure. The goals are to protect the joint with decreasing stress somehow, never run with pain over 2, and especially no limping. Running itself is very natural for the body building strength in muscles and bone, and has a huge emotional aspect. It is part of any athletic participation program, and I think vital to people’s health. 
    The goal in the short term is to continue running your 15 miles per week, while you build a program to keep the pain level between 0-2. Orthotics themselves can both hurt and help, so typically not my #1treatment unless you are a moderate to severe pronator. Pronation jams the big toe joint into the ground increasing the stress. The orthotics have to be full length and require expert attention since the rigidity under the big toe joint in a full length orthotic device may be too much pressure to the joint and have to be modified.
    So, in achieving this 0-2 pain level, without going over the physics of each one, include the following which predictably decrease stress on the big toe joint: spica taping, dancer’s padding, hoka running shoes with rocker bottoms, cluffy wedges, arch supports, Morton’s extensions, shoes with great forefoot cushion like the Ghost, etc. 
    My blog talks about this individual treatment options. I hope this makes sense. Rich 

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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.