Pain in the joint of the big toe is quite common and can be caused by many things including gout, arthritis and injuries. The main thing that often makes the joint more painful is increased movement in the joint by bending the joint upwards (dorsiflexing). The unfortunate thing about big toe and dorsiflexing is that in order to walk, we need to dorsiflex the big toe joint. As we walk, we go from having the foot flat on the ground to a position of "push-off" where the heel lifts off the ground and the toes push down. We need the push-off to propel us forward.
The question is: "How do we get an efficient push-off without dorsiflexing the big toe joint as much?" Here are some solutions which can be used individually or altogether, depending on your case.
With the pain in the big toe joint, sometimes the foot rolls in too much (over-pronates), and then puts too much pressure on the toe. If that is the case, a custom made foot orthosis (orthotic) will help to prevent excess pressure at the big toe and elevate the joint to reduce the amount of dorsiflexion required in walking.
2. Rockered Sole
If the alignment of the foot is good but there is still pain, a rockered sole will help to reduce the amount of bending at the toe. A rockered sole works like the bottom of a rocking chair - the shoe and the foot roll along rather than bending. Most running shoes have a rockered sole and many new types of "exercise shoes" such as the MBT have a rockered sole. The rockered sole can also be added to the bottom of most shoes. It is very effective at reducing excess force at the big toe and is often used in combination with a custom made foot orthosis.
MBT Tunisha
3. Sole Stiffener
If the rockered sole and the custom made foot orthosis is not enough to control pain the big toe joint, the third option is a sole stiffner. By adding a piece of stiff material into the shoe, under the orthosis or to the sole of the shoe, there is a reduction of motion at the big toe which will also help to reduce pain.
As always with any medical condition, it is important to discuss your concerns with your physician and obtain a proper diagnosis. Once it is known what is wrong, it is always easier to treat!
