Sunday, August 19, 2012

Hallux Limitus - Going Barefoot to Fix a Stiff, Painful Big Toe

As my weight peaked at 122kg, my big toes stopped working. The joint was painful and stiff and walking became difficult. For a 30 year old, that wasn't a great place to be. But it's not as if it happened all of a sudden. For years, the signs of what was to come were there but I wasn't listening. The biggest giveaway was a clicking noise coming from my big toes. Simply moving my toes up after a short walk, and there it was, CLICK! I visited a pediatrist who told me that my walk and posture were the cause. I paid close to $500 for a set of paediatric inners-soles to support my feet and correct my posture. It helped, but only a little bit. Hallux limitus (a big toe with limited movement) is hard to fix. My bones were deforming and actually enlarging, making the toe joint incapable of flexing. Surgery, it seemed, was only a few years away. The bones of the big toe (both feet, but the right foot was more painful) would need to be shaved to create space for the joint to move freely. Shaving bones wasn't an exciting prospect for a 30 year old, I can tell you.

After losing 25 kilos on a low-carb Paleo diet, things began to look up a bit. Toe pain became slightly less pronounced and even mobility improved a little. However, while I started integrating exercise into the Paleo lifestyle, I found my toe issue too problematic. Sprinting was particularly painful. Soccer would cause bouts of sharp pain to go on for days on end. I also returned to a corporate job where I wore restrictive business shoes that further limited the movement of my toes and exacerbated the problem. What seemed to be progress quickly reversed to the same old pain and rigidity.

The thing that happens when you get into the Paleo mindset is that your brain kind of sets itself free. You find yourself questioning norms and conventional wisdom; and, to an extent, you get pretty suspicious of the modern world. The seed of doubt is planted when you end up, for the first time in your life, healthy and skinny after eating large quantities of saturated animal fats. Then, things like artificial light, medication and heart-healthy margarine start making you angry. It becomes apparent that almost every time we humans try to outsmart nature by drastically changing our environment to suit us, things go bad. The skepticism in the case of my foot trouble was carried on to a logical conclusion, and all signs pointed to shoes. Were they necessary? Were they even helpful? And how about $500 inner-soles? Would a hunter-gatherer on a low income of berries and bison have considered such creations?

Hunter-gatherer footwear, if used, is made from animal skins. Skins provide protection, but no structural support. At some point, modern society looked at the impeccable design and evolutionary wonder that is the human foot and decided to surround it with a shoe that completely restricts it from performing its job as it had evolved to do. For 30 years, I wore shoes that were supposed to provide "support" for my foot, but were perhaps slowly disabling it.

I decided, it was time to go barefoot. I read about barefoot running, how it strengthened the foot, and how, in fact, the foot would not misbehave if it were allowed contact with its environment. Days before going "barefoot", I found out about the Cluffy Wedge, a brilliantly simple wedge that nudges the toe up slightly and allows the joint to be more flexible while walking. Not being able to find it in Australia (and not wanting to wait weeks before it got posted), I sticky-taped tissue paper to the bottom of my big toes. Within a week, the swelling on the top of my toes disappeared, and I gained a huge improvement in mobility. After that week, I bought a pair of barefoot shoes (Merrell) and another for exercise (Vibram Five Fingers) and found that with the heal dropping because of barefoot shoes (they have no heal or arch support), I no longer needed the makeshift Cluffy. My feet were going to be okay. Yesterday, I bought a pair of Vivo Barefoot Ra (from Athlete's Foot at Westfields Burwood for $189) which are minimalist/barefoot shoes that work well for the office. Now that I no longer look like an idiot in the office with both a suit and sneakers on, I feel my career is going to be okay too.


  1. Hello! I was just diagnosed with Hullux Limitus. I am currently in shoe inserts, and may be getting custom orthotics next month. Do you think that I should ask about barefoot instead? I want to do what is best for my feet. :/

  2. Have you tried the copper insoles?

  3. Hello Fouad!

    i wanted to ask you how your toe is doing now?
    Do you still use the barefoot shoes?
    I have a hallux rigidus and recently thought about going for a forefoot walking and running style.

  4. also curious whether this provided you with long term relief. Thanks!

  5. I've been to podiatrists and doctors. They all prescribed the same thing - orthopedic inserts and shoes that were built like hiking boots or Hokas!

    I was in so much pain (I'm a proficient distance runner) that I considered giving up running. I tried orthopedic inserts, they relieved the pain a bit but radically screwed up my gait and they didn't fit in most of my shoes.

    Finally, I found a sports medicine clinic where the physiotherapist recommended barefoot shoes. I thought he was crazy. His advice contradicted everything everyone was saying.

    Everyone told me to immobilize the joint and he was telling me to totally remove all the "protection" I was getting from conventional shoes and orthotics!

    I was so desperate that I decided to give it a try. I bought Altra Escalante running shoes, because they are zero drop and have a really comfortable foam that makes the barefoot shoes feel like I am running on grass.

    In less than 2 months I was back to running sub 40 minute 10K and I almost forget sometimes that I have Stage 3 Hallux Rigidus.

    Now I wear ONLY barefoot shoes.

    Based on my experience, I think Hallux Rigidus is a condition caused by modern shoes and the weakness they promote in our feet. While there is no "cure" for the damage I did to my joints, strengthening the muscles in my feet has made the difference. Now the muscles in my feet protect the joint, the absence of heels in my shoes take pressure off the joint and my foot strikes in the midfoot (promoting better weight distribution).

    One thing I should add. I do daily exercises to strengthen and elongate my Achilles tendons and plantar fascia. And it took a while to get used to the zero drop. If you're someone who has used shoes with 12 mm heels (conventional running shoes) you're going to need to ease into zero drop or you'll mess up your Achilles.

    I hope this helps.