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The big toe may only be small, but that doesn’t mean it doesn’t escape injury. This is particularly true for runners, as the big toe serves a critical function, creating leverage to generate forward momentum when you run. As a result, big toe injuries are common, particularly overuse injuries. While these injuries may only be minor in pain and treatment, they may upset your training programme or your running progression as they take considerable rest time to heal.
Hallux Rigidus – This is a form of degenerative arthritis that causes rigidness in the joint at the base of the big toe. It causes pain and stiffness, and over time makes it increasingly difficult to bend the big toe. When it comes to treatment, orthotics are recommended to reduce the stress on the joint, and anti-inflammatories to reduce the swelling. In addition, investing in a pair of runners with rocker-bottom soles or a large toe box can help relieve the pressure on your toe. However, as this is a degenerative condition, surgery may be needed in the long term.
Hallux Valgus – This is the medical term for a bunion, a bump that occurs on the outer side of the big toe. While a bunion is known as the bump that occurs, it is a reflection of the big toe leaning inward which throws the bones out of alignment. As bunions are progressive and get worse over time, surgery may be needed in the long term to relieve bunion pain. However, most people can comfortably live with them by making some adjustments such as modifying your running shoes to take pressure off the outside of your foot or investing in special bunion pads that help minimise pain. Anti-inflammatories and ice therapy may also be recommended if the bunion is particularly swollen and painful.
Turf Toe – This is a sprain of the big toe ligaments and one of the most common toe injuries that occurs in runners. An x-ray is typically ordered to ensure no bone is broken. Similar to an ankle sprain, recovery can be lengthy as the ligaments need time to heal. Rest, ice, compression and elevation is recommended. In addition, sometimes a doctor may recommend an air-cast to immobilise the joint while it is healing, and taping the toe for a few weeks while you return to running to reduce the stress on the area.
Sesamoiditis – This is chronic inflammation of the sesamoids, the small bones embedded in the tendons that are located in the ball of your foot, just beneath the big toe. The sesamoids act as a lever for tendons, helping move the big toe, and so this injury occurs as a result of overuse. This is generally easy to diagnose as pain can be felt while pressing down on the ball of your foot. Padding can be used to cushion the area or else taping the toe to relieve tension in the area, or in more serious cases immobilisation may be recommended.
If the pain is severe, it may not be a case of sesamoiditis, but a more serious stress fracture in the sesamoid. This could be the case if it is particularly sore to walk on the foot when barefoot and so an x-ray or MRI will be needed to confirm.
If you suspect you may need orthotics or would like a running assessment, please contact us here to arrange an appointment. At Ballsbridge Physiotherapy Clinic, we have a team of chartered physiotherapists to assist you if you have suffered a running related injury. Our sports specialists Olive and Dave are trained in treating a wide range of sports related injuries and in addition offer assessments to evaluate your training concerns. To book an appointment, fill out our online contact form.