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Big toe

post #1 of 25
Thread Starter 
This doesn't make sense to me, but I'll throw it out there anyway. Is it possible that skiing would aggravate arthritis in one's big toe?

I ask because I have had some pain for the last year and a half or so in the area around my right big toe. It got to the point last spring (March, maybe) that I actually went to the doctor; they x-rayed it because it was inflamed, and it turned out that there was some arthritis in there.

I play tennis year-round, and that's really when I notice the pain (pushing off or changing directions). Over the summer, the pain subsided. But now it's started up again, and BIG TIME -- worse than last year, in fact. The only thing I can think of that I'm doing differently is skiing. It doesn't hurt when I ski, and I can't imagine how I could be aggravating it, but I thought I'd ask ....
post #2 of 25
I have been dealing with osteoarthritis in my neck and knee for a long time. (Don't get crazy about the term "arthritis." It only means "painful joints," and has nothing to do with rhuematoid arthritis, which is a debilitating, progressive disease.) I never worry about activities that are pain free while I'm doing them, but I back off pretty quickly if the pain gets worse while I'm exercising. It's important to avoid imflamation, and to treat the inflamation when it starts. I use lots of ice and ibuprofen, and I rarely need to restrict my activities. Your results may vary.

i hoope this helps.

John
post #3 of 25
Thread Starter 
Right; this is a degenerative kind of thing. Hallux rigidus, I think it's called. It doesn't have to do with any other joints.

It does get worse and lead to a non-functioning big toe, though. (It's what I have in common with Shaquille O'Neal!) It would screw up one's athletic life, for certain. I have used ice and ibuprofen, but I've had to cut back on ibuprofen because I'm starting to destroy my stomach.

I don't have toenail problems (boots fit fine, I think; I have footbeds, too). I just wonder if there is some technique thing where I'm doing something wrong on that foot.
post #4 of 25
segbrown:

Is the pain related almost exclusively to the largest joint for the big toe? If so, that's exactly what I have. I was first diagnosed with it nearly 10 years ago. Initially, i was enlarged, tender, and occasionally painful. It pretty much ended my jogging career, but I was looking for just about *any* excuse to do that.

Anyway, it has slowly become larger and more painful and my doc just told me about two weeks ago that I need to think seriously about surgery. He gave me the name of an interesting-sounding procedure, but that's at home rather than here with me. If you're interested, I can post it later.

I don't think there's much you can do that will help the situation. I just had my ski boot punched out a little to give more room around that joint. It doesn't hurt at all while I'm actually skiing, but I definitely feel it afterwards.

Bob
post #5 of 25
Try paracetamol tablets 500mg - take 2 four times daily REGULARLY (unless you hvae liver problems). It should help the pain. Once you have been on this dose for a while (2-3 weeks) try decreasing the dose - & find the level you need.

Add the anti-inflammatory drug as you need for flare ups of pain.

This should save the stomach a little.

Don't forget - food or milk with the anti-inflammatory.
post #6 of 25
Thread Starter 
Quote:
Originally posted by Bob.Peters:
segbrown:

Is the pain related almost exclusively to the largest joint for the big toe? If so, that's exactly what I have. I was first diagnosed with it nearly 10 years ago. Initially, i was enlarged, tender, and occasionally painful. It pretty much ended my jogging career, but I was looking for just about *any* excuse to do that.

Anyway, it has slowly become larger and more painful and my doc just told me about two weeks ago that I need to think seriously about surgery. He gave me the name of an interesting-sounding procedure, but that's at home rather than here with me. If you're interested, I can post it later.

I don't think there's much you can do that will help the situation. I just had my ski boot punched out a little to give more room around that joint. It doesn't hurt at all while I'm actually skiing, but I definitely feel it afterwards.

Bob
Yep, this sounds like what I have. Except the pain has increased into the ball of my foot and my second toe in the past few weeks. I love skiing, but I REALLY love tennis, and it will be very difficult to play if I can't push off. What I'm trying to figure out is whether skiing truly aggravates it, because tennis doesn't seem to. It's definitely too early to decide to quit skiing over it, but if it comes down to a choice, I'd probably choose tennis.

The surgery: is it where they file down the bone spurs that have developed in the joint? Apparently there is also a joint replacement they can do, too. I am not to that point, but as you say, it just gets worse.

[ January 15, 2003, 06:39 PM: Message edited by: segbrown ]
post #7 of 25
Thread Starter 
Quote:
Originally posted by disski:
Try paracetamol tablets 500mg - take 2 four times daily REGULARLY (unless you hvae liver problems). It should help the pain. Once you have been on this dose for a while (2-3 weeks) try decreasing the dose - & find the level you need.

Add the anti-inflammatory drug as you need for flare ups of pain.

This should save the stomach a little.

Don't forget - food or milk with the anti-inflammatory.
Does that need a prescription, I presume? And food or milk would help with the pain relief. I really do have a tough stomach, so I'm lax with that sort of thing. But I had a little scare last summer, and so I'm trying to lay off the ibuprofen a little.
post #8 of 25
OOOppps - forgot you guys don't know it as paracetamol.... [img]redface.gif[/img]

Ummmm - cannot remember american generic name(drug name)..

What do you guys call Tylenol? it is that stuff - so no script needed.

If you want I can find the reference to the info that comes out with the australian drug guidelines - developed by specialists in each field of medicine & used in about 9 countries already(& growing).

Anyway - the go is that for OSTEOarthritis that is the best way to manage pain - so they tell us....THIS YEAR....
post #9 of 25
Quote:
Originally posted by segbrown:
</font><blockquote>quote:</font><hr />Originally posted by Bob.Peters:
segbrown:

Bob
Yep, this sounds like what I have. Except the pain has increased into the ball of my foot and my second toe in the past few weeks. I love skiing, but I REALLY love tennis, and it will be very difficult to play if I can't push off. What I'm trying to figure out is whether skiing truly aggravates it, because tennis doesn't seem to. It's definitely too early to decide to quit skiing over it, but if it comes down to a choice, I'd probably choose tennis.

The surgery: is it where they file down the bone spurs that have developed in the joint? Apparently there is also a joint replacement they can do, too. I am not to that point, but as you say, it just gets worse.
</font>[/quote]Seg:

I checked my note from the doc last night. Mine is, like you said, hallux rigidis. Here's a short explanation of the two types (from this site - http://www.balanceorthofoot.com/bunions.htm):

. Definition: There are two main types of bunions. The most common type, known as a hallux valgus, is a painful enlargement at the base joint of the big toe on the inside of the foot. The skin around the joint can become swollen, red, and tender, making it painful to walk or to even wear shoes. The big toe may begin to angle toward the second toe, forcing both toes out of alignment. A second type of bunion, a hallux rigidus, is related to arthritis of the big toe. In this condition, a bump develops on top of the base joint of the big toe, usually without disrupting the toe alignment. It is characterized by arthritic pain and limited motion in the joint. Similar to a hallux valgus, a hallux rigidus can make walking and wearing shoes very painful. Small bunions are also known to develop on the outside of the foot near the base of the little toe. These are known as bunionettes, or “Tailor’s Bunion.”

You're right about the choices. There is joint replacement, but that sounds a bit extreme to me still. There's removal of the spurs (chiseling, actually, as I understand it), but my doc seems to feel that removal of the spurs is a somewhat temporary fix.

The other choice is a procedure called cheilectomy. If you Google that, you will find a number of references. My vague understanding from talking to my doc - who does not actually do the procedure - is that step one is the removal of a lot of the calcium (chiseling,again). Step two is to actually cut out a portion of the next bone out from that joint, leaving the surface of that bone (where it contacts the joint) intact, but fusing the remaining segments of the bone so that the bone ends up being shorter.

According to my doc, this is a pretty effective treatment. I don't know how it might affect a tennis player, but it does sound like if you let this go untreated long enough, it will eventually result in severe incapacitation of that joint.

Good luck,

Bob
post #10 of 25
Ok - checked the book
& the paracetamol is still the first choice...

The other comment they make is that much of the problem from osteoarthritis comes from poor alignment & that people should be checked by a podiatrist....

As I am told MOST bunions (if that is what you have) are gait related that sounds like a good plan.....
post #11 of 25
Quote:
The other choice is a procedure called cheilectomy. If you Google that, you will find a number of references. My vague understanding from talking to my doc - who does not actually do the procedure - is that step one is the removal of a lot of the calcium (chiseling,again). Step two is to actually cut out a portion of the next bone out from that joint, leaving the surface of that bone (where it contacts the joint) intact, but fusing the remaining segments of the bone so that the bone ends up being shorter.
I had this done in March, and man, I wish I had done it sooner! I had the same problem, and it got to the point where walking in shoes was a real pain. It worsened rapidly, and in a years time, I was limited to wearing only soft canvas shoes and limping. I had surgery March 15, and skied Mt. Bachelor in May (albeit, not very well! )

I feel great now, and it's as normal as the other foot. I would highly recommend it if your physician thinks it will help.
post #12 of 25
Quote:
Originally posted by disski:
Ok -

The other comment they make is that much of the problem from osteoarthritis comes from poor alignment & that people should be checked by a podiatrist....

Problems at the met head are generally developed by foot dysfunction and they are certainly going to be aggravated by foot dysfunction. If you have limited ankle flexion (dorsi flexion) you may be straining a lot of connective tissue while you ski with a lot of that strain focusing on the joint you're having trouble with. Being pushed too far forward in the boot will also add to the strain as will serious pronation. If there is anything in the back of your boot (spoilers and such) that can come out take them out to allow you to stand straighter. You can try a heel lift to open the ankle joint a little which may relieve stain. IF YOU DON'T ALREADY HAVE A FOOT BED YOU NEED TO GET A GOOD ONE NOW. Either by a very reputatable bootfitter or a medical professional. (Podiatrist or Pedorthist). The heavy drug use and surgical procedures are best left until after you try to find relief by improving the foot function.
post #13 of 25
Thread Starter 
Quote:
Originally posted by L7:
</font><blockquote>quote:</font><hr />Originally posted by disski:
Ok -

The other comment they make is that much of the problem from osteoarthritis comes from poor alignment & that people should be checked by a podiatrist....

Problems at the met head are generally developed by foot dysfunction and they are certainly going to be aggravated by foot dysfunction. If you have limited ankle flexion (dorsi flexion) you may be straining a lot of connective tissue while you ski with a lot of that strain focusing on the joint you're having trouble with. Being pushed too far forward in the boot will also add to the strain as will serious pronation. If there is anything in the back of your boot (spoilers and such) that can come out take them out to allow you to stand straighter. You can try a heel lift to open the ankle joint a little which may relieve stain. IF YOU DON'T ALREADY HAVE A FOOT BED YOU NEED TO GET A GOOD ONE NOW. Either by a very reputatable bootfitter or a medical professional. (Podiatrist or Pedorthist). The heavy drug use and surgical procedures are best left until after you try to find relief by improving the foot function.</font>[/quote]Thank you... this is very helpful. I'm starting to see where I could be straining it. It's my right foot; my right ski doesn't lie as flat as my left, and sometimes I consciously compensate, which causes my to sort of "bow out" my ankle. I don't imagine this is the best thing to do. :

I've thought about doing some work on it (shims or something) but haven't gotten around to it. I do have footbeds, but they are from Surefoot (not a doctor) and sometimes the right one feels funny under the ball of my foot.
post #14 of 25

I need surgery for hallux rigidus - anyone had it?

I have been diagnosed with hallux rigidus on both feet and have seen two doctors and both doctors said I need surgery. I would really like to talk with someone who's already had this surgery because I need to know if I'll be able to get along after surgery by myself. I've been putting this surgery off but it's really getting painful now.
post #15 of 25
I had it done about 2 years ago,best thing I ever did.

I was on crutches for about 2 weeks and this made things challenging t be on your own.

Then of course there is driving.My foot was in a cast for about 10 days,then a walking boot for a really long time.(had some healing problems)

All is good now and I am back to running pain free.

It is also fine in my ski boot.

Terry
post #16 of 25
Try this thread. Bob Peters experience with the procedure.
post #17 of 25
tcarey and segbrown share their experience with the procedure in the same thread
post #18 of 25
Thread Starter 
I forgot about this old thread! As shown in the other thread, I did finally have the surgery.

But I'm posting because I figured out what was causing the pain during ski season ... it had nothing to do with boots, alignment, footbeds, whatever. It was high heels.

I rarely wear them, but around the holidays (Christmas, New Years) and other dress-up times, I do. It just happened to coincide with the beginning of ski season, so that's what I was connecting.

Correlation does not prove causation, of course, which this proves. Or something.
post #19 of 25
Quote:
Originally Posted by segbrown View Post
I forgot about this old thread! As shown in the other thread, I did finally have the surgery.

But I'm posting because I figured out what was causing the pain during ski season ... it had nothing to do with boots, alignment, footbeds, whatever. It was high heels.

I rarely wear them, but around the holidays (Christmas, New Years) and other dress-up times, I do. It just happened to coincide with the beginning of ski season, so that's what I was connecting.

Correlation does not prove causation, of course, which this proves. Or something.
Well, sure (smacking my forehead)!

That must have been my problem, too.

I'm getting rid of those shoes tomorrow.
post #20 of 25
Quote:
Originally Posted by Bob Peters View Post
Well, sure (smacking my forehead)!

That must have been my problem, too.

I'm getting rid of those shoes tomorrow.
Actually, Superfeet makes an insert for high heeled shoes. It straightens alignment and shifts weight from the ball of the foot to the heel.

So you can still step out in style, Bob.
post #21 of 25
Thread Starter 
Quote:
Originally Posted by Acrophobia View Post
Actually, Superfeet makes an insert for high heeled shoes. It straightens alignment and shifts weight from the ball of the foot to the heel.

So you can still step out in style, Bob.
(pics of Bob, of course. You always do such nice TRs!)
post #22 of 25
Quote:
Originally Posted by Bob Peters View Post
Well, sure (smacking my forehead)!

That must have been my problem, too.

I'm getting rid of those shoes tomorrow.
But then what are you going to do about the rest of your wardrobe ???
post #23 of 25
Quote:
Originally Posted by Acrophobia View Post
Actually, Superfeet makes an insert for high heeled shoes. It straightens alignment and shifts weight from the ball of the foot to the heel.

So you can still step out in style, Bob.
Have you tried them Acro ? Do they really work ? I'm trying to picture that weight shift & can't quite do that. I mean, my toes would still be lower than the heel so would still be bearing most of the weight I'm thinkin'.
post #24 of 25
Quote:
Originally Posted by 911over View Post
Have you tried them Acro ? Do they really work ? I'm trying to picture that weight shift & can't quite do that. I mean, my toes would still be lower than the heel so would still be bearing most of the weight I'm thinkin'.
Most of your weight is still at the ball of the foot; the insert just shifts some of it back. The arch support also makes a huge difference. Also, it doesn't take up any volume in the shoe to speak of. They're called Superfeet Dressfit inserts.

You taking notes on this, Bob?
post #25 of 25
I had surgery on my left big toe about 8 years ago because I had a really big bone spur. The doc basically shaved the bone down so I could flex my foot without there being bone to bone contact. It was very sore and I really could'nt do much as far as sports are concerned. The first thing I thought about in the morning was putting that foot on the floor. The surgery helped alot but It still bothers me when I stub it or flex it to much. It's alot better than it was. The recovery was tough because I could'nt put weight on it for several weeks. I have a little pain putting on my ski boots but after they're on it's not a problem. If you have it done forget about tennis for a while. It will be worth it in the long run.

Good luck
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