Hallux Rigidus or Hallux Limitus

Causes
This condition is characterized by pain and/or restriction of movement at the joints of the big toe. To achieve full demipointe the metatarsal phalangeal joint must be able to make a 90 deg. angle. Dancers who start later in life may lack this much mobility. A dancer without mobility who forces a high demipointe will cause the bones in the joint to impinge on each other. If this is done repeatedly, impingement spurs will develop leading to even further decreased motion in the joint, inflammation and eventual degeneration of the joint.
Compensations for lack of full mobility include sickling. This position will decrease impingement but it is not an esthetically acceptable line and puts the dancer at risk for ankle sprains. An acceptable and safe compensation for this condition is a half-demipointe position. The dancer must learn to rise onto the ball of the foot without forcing the foot into full demipointe.

Treatment
Treatment for hallux rigidus is rest and ice in the acute stages. Ice massage (rubbing an ice cube on the big toe joint for 5 minutes) will help to decrease the inflammation.
A toe spacer placed between the big toe and the second toe will help align the toes for optimal motion in the joint. Stretching of the foot can be done to help improve flexibility. The stretch into a demipointe position can be done in a non-weight bearing position, in a pain free range and should be held for 30 seconds. The dancer should assess the available pain free range of the joint and learn to work within that range. Mobilization of the metatarsal phalangeal joint by an experienced physical therapist is also quite effective.