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Hello All,

Some advice would be appreciated here.....
70 year old very active woman.
Unilateral hallux limitis with associated joint margin narrowing.
Seems to be compensating at push off via the hallux IPJ.
Said IPJ very painful.....joint integrity is OK however.
Footwear modifications? She wont come at rocker soles etc..Wont consider Sx either.
Any advice here would be welcome.
Thanks.
Chris Williams

 

Functional or structural?

? IP sesamoid?

She does not really have an option if she wants to get better. Mortons extension is only option.

 

Hi Chris

Get a piece of 6mm felt or PPT and stick it under the shaft of the proximal phalanx. Stick it to her foot and she can walk around on it for a bit to see if it will help. If it does help, stick it under the insole.

However, if there is hyperextention of the IPJ with retraction of the EHL tendon, it might make the distal phalanx too elevated and closed-in shoes will irritate. Works fine with IPJ hyperextention otherwise.

Rebecca

 

Chris,

Stiff shoes or a carbon fiber plate under sock liner in flexible shoes. I recall a study that showed reduction in hallux pressure with a rigid shoe. It might prevent pain with hyperextension. Most running shoes have a bit of a rocker, will she wear them? I consider the pad under the prox phalanx like an "in shoe" rocker. You could do many things along those lines like cutting a hole sub hallux in the sockliner of her running shoes, if she would wear them.

Regrds,

Eric