Hallux rigidus

Hallux rigidus is a joint condition affecting the big toe (hallux). It involves a progressive loss of mobility in the metatarsophalangeal joint of the first toe, often associated with cartilage wear — it is a form of osteoarthritis of this joint.

In runners, this condition can cause pain during foot push-off in the stride. Over time, joint stiffness can make running difficult and may require adjustments to training or equipment.

The metatarsophalangeal joint of the big toe, located at the base of the hallux, plays an essential role in the push-off phase of the stride, in foot balance and in transmitting forces forwards. When the cartilage of this joint gradually wears away, the joint becomes less mobile, which can cause pain and stiffness in the big toe, especially during the forward push-off phase of the foot.

Hallux rigidus can affect runners of any age, but the risk of developing it increases with age. It particularly affects people with a history of big toe injury or who take part in sports involving repeated impacts.

Running-related factors

Running places heavy demands on the forefoot, especially during the push-off phase. These repeated stresses can accelerate joint wear in some people, and the repeated impacts of running can promote chronic irritation of the big toe joint. Shoes that are too stiff or too narrow in the forefoot can increase the stresses placed on the joint.

Individual factors

Certain anatomical features of the foot can predispose to hallux rigidus. Risk factors include a history of big toe injury, sports involving repeated impacts, a high-arched foot (pes cavus), biomechanical abnormalities of the foot, unsuitable footwear, and age.

Hallux rigidus can present as pain at the base of the big toe, joint stiffness, difficulty bending the toe, pain during push-off when running and, sometimes, a bony bump on top of the joint. In runners, pain often appears during the forward push-off phase of the foot.

When to see a doctor?

A medical consultation is recommended if pain persists despite adjusting your training, if big toe mobility decreases markedly, or if walking becomes painful. A clinical examination, sometimes supplemented by an X-ray, can confirm the diagnosis.

It is not always possible to completely prevent hallux rigidus, particularly when anatomical factors or age are involved. However, choosing suitable shoes (stiff or rocker sole, sufficiently wide forefoot), avoiding very hard ground and regularly strengthening the foot can limit the worsening of symptoms in runners.