Thread: Hallux Limitus
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Old 09-01-2003, 06:19 AM   #11
Junior Member
Join Date: Nov 2002
Location: washington,dc
Posts: 30
metatartus HB User

No mention was made of stages--one of my complaint is that my doctors seem so "unscientific" in discussing my condition--I get most of my detailed info from the web. Here is some info on stages from a really good site--
Grade 1 : Functional Hallux Limitus
This is the primary stage of the degenerative process and is often associated with a hypermobile first ray foot type.
Available range of motion is close to normal (60-65dergrees) and symptoms may or may not be present. It is appropriate to introduce orthotic therapy at this stage if a family history of hallux limitus exists or if changes can be detected on X-ray.
This will slow or stop the progression of the condition.(Dananberg et al, 1996)
Manipulative therapy can be introduced as a prophylactic maintenance of ROM.

Grade 2 : Mild Hallux Limitus
In this stage, 35-55 degrees of dorsiflexion ROM is available at the joint. If radiographic changes are not evident then ROM may be restored with manipulation, short term NSAIDís and biomechanical alteration ie. Orthotic therapy.

Grade 3 : Moderate Hallux Limitus
15-30 degrees of dorsiflexion is available and marked joint space changes can be seen. Conservative management should be more aggressive to be effective.
Manipulation must be performed regularly (by the patient at home)
Heat therapy is applied before exercising the joint followed by ice application to reduce inflammation.
Immobilization of foot hypermobility using Low dye strapping and the instigation of NSAID therapy. If this treatment regime is successful then orthotic therapy is indicated.

Grade 4 : Severe Hallux Limitus.
Motion is less than 15 degrees and the joint space has severe osteophytic proliferation.
Motion is extremenly painful, therefore in this case, immobilization with Mortonís extension and appropriate footwear is indicated.

Based on the above I am grade 4, almost no motion