Functional hallux limitus is defined as a limitation in motion at the first metatarsophalangeal joint when functioning. It only occurs during gait. There is normally a full range of motion available during non-weight bearing (unless there is a superimposed structural hallux limitus). The easiest way to determine if a functional hallux limitus is present is to simulate ground reaction forces on the first metatarsal head and the IP joint of the hallux. How easy is it to dorsiflex the hallux? If more force is needed to dorsiflex the hallux than the force applied to the first metatarsal head, then consider functional hallux limitus is present.
There is some controversy as to if functional hallux limitus even exists as an entity and also if functional hallux limitus is primary (i.e. is the cause of abnormal function) or if it is secondary (i.e. the result of abnormal function). There is plenty of theory around functional hallux limitus but not a lot of research around it.
There has been an attempt to reconceptualise functional hallux limitus in terms of changes in stiffness of the first metatarsophalangeal joint. Functional hallux limitus treatment involves anything that can facilitate plantarflexion of the first ray or medial column of the foot, such as the Kinetic Wedge. This lowers the stiffness curve of the joint and facilitate hallux dorsiflexion during gait. Sometimes hallux manipulation can help.
Related posts:
Comments on this entry are closed.