Management of Hallux Rigidus in Athletes

Hallux rigidus can be a major limiting factor for athletes due to pain, stiffness, and weakness. Any sporting activity that requires significant dorsiflexion of the hallux to perform at peak level will be negatively impacted by a painful stiff toe due to limited push-off strength and propulsive power. There are reasonably good nonsurgical options to help an athlete to extend their activities and career, and should be exhausted before indicating for surgery. Once nonoperative measures are no longer able to meet the satisfaction of the patient, several surgical options are available. The surgical choice depends upon the grade of disease and expectations of the athlete. In running sports, the initial goal is always to increase and maintain range of motion, while reducing pain. This is easier to achieve in early stages of hallux rigidus. In later stages of hallux rigidus, it might be possible to increase range of motion, but the underlying degenerative changes of the joint might continue to cause pain with activities. An arthrodesis is the most reliable way to achieve pain relief, but will also have most impact on the ability to play certain sports.