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Trigger hallux apex

Discussion in 'Biomechanics, Sports and Foot orthoses' started by jos, Sep 19, 2011.

  1. jos

    jos Active Member


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    Just wondering if anyone has suggestions about how to deflect pressure from the apex of a trigger hallux? Apart from the silipos style padded toe caps to add cushioning, are there any other suggestions/ modifications that can be added to the orthotic ?
     
  2. Jos what is your definition of Trigger hallux.

    Seems a rare Bird - taken from an abstract

     
  3. jos

    jos Active Member

    The distal phalanx is plantarflexed, so that pressure goes directly onto the apex (I was taught many years ago that this was a 'trigger' toe). Sort of like a hammer toe of the hallux. I have seen about 3 or 4 in 15 yrs and is often present with hallux limitus or rigidis. I just wondered if there is some sort of orthotic modification.?
     
  4. efuller

    efuller MVP

    I was confused by apex. I didn't know if that was head of the proximal phalanx hitting the shoe dorsally or the distal end of the toe diving into the ground. If the pain area is the tip of the toe, I would not put the modification in the orthotic. The modification that I want, if the shoe would allow, is to put a soft mass under the IPJ. The mass would have to be large enough so that the distal end of the toe does not touch the floor. If you put that on an orthotic the patient would have difficulty getting their toe down to the end of the shoe. I've had some patients that like a slip on pad that they put on under their sock. Some don't want to be bothered.

    Eric
     
  5. Fraoch

    Fraoch Active Member

    Not able to change toe position. What I have done with marginal improvement in pain/callus is to accommodate; REALLY deep toe box, insole/CFO with super thick forefoot padding, cut out under apex and sometimes gel button in the aperture.
     
  6. Peter1234

    Peter1234 Active Member

    Is it worth trying to mobilize the hallux at the IPJ?

    I saw a patient with trigger hallux the other day, an eleven year old boy. There was very little dorsiflexion available at the IP joint of the hallux.
     
  7. Peter1234

    Peter1234 Active Member

    and does anyone know of any literature that covers the treatment for 'trigger hallux'?
     
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