Hallux limitus simply means stiffness of the 1st MTP (big toe) joint. For such a small joint it has a very important role in foot function. During the propulsive phase of walking the 1st MTP joint is extended backward as we move up onto our forefoot just before toe-off, adequate movement in this joint is crucial in allowing the foot to progress from heel to toe with ‘straight-line’ mechanics.

Extension of this joint also places tension on tissues underneath the foot (plantar fascia) which help to lift the arch of the foot and stiffen the forefoot (something known as the windlass mechanism) so that it functions as a rigid lever in order to enable effective propulsion.

Restriction in extension of this joint limits the ability of the foot to progress in a straight-line and the foot is forced compensate by twisting away as the heel leaves the ground therefore introducing increased rotational forces to the lower limb. Additionally without adequate extension of the joint the windlass mechanism fails to initiate leaving the foot inadequately stabilised during the propulsion phase.

Hallux limitus is an underlying cause of a number of conditions including Iliotibial Band Syndrome, Plantar Fasciitis, and some blistering or callus formation in the arches of the foot. Pain in the big toe itself may also result from the restriction, generally in the sesamoid complex which these are the small bones that sit under the big toe joint and are susceptible to stress fractures.

Video gait analysis is used to identify the presence of Hallux limitus and to assess the compensatory movements it may be causing, and to determine whether treatment with orthotic devices will help.