Turf toe/ hallux limitus/ big toe arthritis and golf

[ChaosTheory]

I am suffering from what is known as hallux limitus, which is Latin for big toe doesn't like to bend. RIght big toe, right handed golfer. Turf toe is the same basic thing. I first noticed it when working or doing home projects, when I would do something on my knees with my toes curled upward, the way anyone would typically kneel. It wouldn't hurt while doing that, but the next days would be bad.

 

Now it's cropping up after playing golf. I still have enough range of motion that walking is not a problem. But pushing off the toe in the swing makes it hurt. As when I first had it, with golf the pain is mostly afterwards, not during. But it hurts a lot.

 

I've been to a podiatrist who said the surgery fix is not that reliable. (If it gets to that point, I'll search out a sports orthopedic surgeon.) I hear shots aren't very reliable either. He recommended higher arch supports, which take some of the load off the toe joint. That helps to some extent, but it doesn't change what happens when the foot gets up on the toe. He (and youtube) also showed me how to tape it so that the extension upward is minimized. That seems to cause a different issue, where the joint is better protected during the swing, but more stressed during walking by not being able to flex enough. Or something like that. The same thing happens when I walk in hiking boots that have stiff soles. I feel good during the walk but as soon as my feet get out of them and return to normal flexing, the toe hurts. Where if I just walk with regular athletic shoes, very little pain while walking, and no pain later.

 

A couple of solutions would be to ride a cart and wear stiff soles or tape job, or walk in regular shoes and then slip on a special shoe to swing. Not very convenient, to say the least. I'm trying to walk golf 3X a week for the exercise. My more realistic options are:

-Conserve swings. Very little practice, and be careful with practice swings.

-Change the swing to not push off the toe. I swing a lot like Moe Norman, and unlike me, he rolled his right foot inward through impact rather than pushing off the toes. He finished on his toes, but didn't push off them conventionally.

I might be able to do that, and/or also to flare my foot out and see what that does.

-Swing with less effort. Which I've been starting to do anyway due to a neck problem. Everything in between my toe and my neck is pretty functional, lol!

 

I'd love to hear how anyone else has coped with this.

[tmgolf25]

I have a similar issue. About twice a year I will wake up and my toe feels like it's on fire and it's painful to do anything. A few days go by and I'll wake up with no pain again. It's such a weird/frustrating thing.

[rwc356]

I have arthritis in both feet - which often results in pain in the toes and/or arch. Arch supports have helped as well as prescription pain meds. I take a pain pill the night before I play and then again when I play. I try to walk instead of riding if possible. Walking on the course seems to be less painful than walking on the sidewalks and my feet seem to stiffen up when I'm in a cart which then creates pain when I get out and swing . I have cut back on practice and have ordered a walking stick seat so I can relax between shots - hopefully that will help.

 

All in all it sucks, but so far I have been able to keep playing - though many of the rounds are just 9 holes. Best of luck with your condition.

[Justsomeguy]

Exact same issue. There are a couple of hard NO's.

No tight shoes, no running or jogging, no extended standing.

When it acts up, I make sure to enhance the range of motion at night before bed.

Hold the foot w one hand, take toe in other hand and pull gently to make space.

Then bend all 5 toes down, all 5 up, then leave 4 up and bend big toe down, then 4 down big toe up.

Then gently pull to make space and repeat.

Do it every night before bed. Helps keep what you've got.

[ChaosTheory]

Anyone try:

Rigid inserts?

Taping your toe?

 

Any luck with cremes or gels?

Supplements?

Acupuncture?

 

 

 

My experience with taping the toe is mixed. If I restrict the motion too much, I think walking causes some pain later. (I suspect it would be similar with a rigid insert?) If I don't restrict the motion enough, it does nothing. There might be a Goldilocks zone in there, but I can't say for sure.

[Justsomeguy]

Never done inserts.

Wish I could figure out how to beat plantar fasciitis.

[Socrates]

Big toe joint injuries are nothing to take lightly. You need to do whatever it takes to get this healed. As your podiatrist said, surgery doesn’t usually go well. You might need a forced period of rest. Do you have a college football team nearby? I might try and seek out one of their team drs or Physio’s since these guys see turf toe all the time. Turf toe can be a career ended in football and likely just as bad for a golfer. This needs your full attention so it doesn’t become chronic.

[Dr.Frankenputz]

I think the key will be finding the right shoe.

Creams can be hit & miss. Can always try voltaren gel or a similar rx depending on where you live.

If it gets to thinking about surgery I’d definitely recommend either a good podiatrist or a good foot & ankle trained ortho. Most sports ortho probably don’t do enough feet. Definitely consider getting 2 different opinions.

How old are you by the way Snowman?

[martynbirch]

I had metatarsal fusion some 5 years as mine was so bad it had become hallux rigidus. 12 week lay off but all good now. I struggle to run that far and really use my feet well in the golf swing but that was the same before my op!

[ChaosTheory]

I'm 60. I appreciate the advice that this is not something to ignore. I believe that.

 

Here's an interesting anecdote. I had my first session with an acupuncturist for headaches. I did it last year, and after several sessions my headaches stopped. Much to my amazement. So anyway, I asked her about the toe, and she said she would include some needles for that. That was Monday after having walked nine holes. Tuesday it felt quite good, which would not normally have been the case. Yesterday I hit 60 shots in a teaching studio, in plain New Balance sneakers, so no real support. Yesterday and today, it still feels good. This would not have been the case! So I'm thinking the acupuncture did something good. I'm going to be going for a few weeks for the headaches, and will report back on the toe if it stays good, or not.

[Jersey golfer]

Coming from someone who has suffered with Hallux Rigidis for over 20 years, I understand your pain. I have been to several podiatrists and an orthopedic surgeon. The three options I was given were Kellner procedure, fusion or an implant. None of which would give totally relieve pain and would probably create difficulty walking. My podiatrist made custom orthotics for me (fortunately covered by my insurance). I look for golf shoes with a stiff sole and a soft upper. Normally I live in my sneakers. I'm 68 and usually walk 18 unless it is extremely hilly or spread out. Breakfast before a round always includes 2 or 3 Advil.

 

Don't be too quick to do any surgery. Whichever procedure is used it is not reversible. Good luck.

[hackerboy]

Have become somewhat an expert on this (not by choice). I’m in my 3rd year of Limitus, have been to podiatrist, and have medical background. I can tell you my experience, which may be different from yours. We started out with an orthotic variant, a reverse Morton extension. Basically this leaves an opening under your big toe to allow movement in the plantarflexion direction (at this stage it’s the dorsiflexion that’s the problem/ I’m sure you can find some who disagree, but that’s the prevailing thought). We fabricated the orthotic with a Lynco and adherent felt to create comfortable reverse M. Anyway, I found that helped out, not all the time, but frequently. I later tried taping, using kinesiology tape. Seemed to slightly help but not enough to continue using. My current solution which I strongly believe to be the best is finding the right shoes. For me, slightly Wide or larger New Balance, Skechers, and Ecco are the only shoes that seem to noticeably reduce the problem. Having a rocker bottom like the former 2 is important to me. I have spent a fortune on shoes, and the right pair/fit is the best solution until they loosen up, start to bend a bit, then time for new pair/ more stability. I am not a medicine person, so the rare Aleve works wonders in stopping the inflammation short term. Unfortunately it is a progressive inexorable story/ I’m 64, hope to slow it down for the next decade. I practice a lot, but only wear my most comfortable proven sneakers for that. Thanks. And look forward to hearing others.

[ChaosTheory]

Thanks, great info, keep it coming. I'm particular glad to get the shoe thoughts.

 

OK I hit a bucket at the range today. Last time I did that, I was in pain afterwards. Tonight, nothing to speak of. I think the acupuncture really helped. I'll be getting more of it in the coming weeks with my headache treatments, so I'll have a longer term report eventually.

[ChaosTheory]

.... My current solution which I strongly believe to be the best is finding the right shoes. For me, slightly Wide or larger New Balance, Skechers, and Ecco are the only shoes that seem to noticeably reduce the problem. Having a rocker bottom like the former 2 is important to me. I have spent a fortune on shoes, and the right pair/fit is the best solution until they loosen up, start to bend a bit, then time for new pair/ more stability. I am not a medicine person, so the rare Aleve works wonders in stopping the inflammation short term. Unfortunately it is a progressive inexorable story/ I'm 64, hope to slow it down for the next decade. I practice a lot, but only wear my most comfortable proven sneakers for that. Thanks. And look forward to hearing others.

 

The golf shoes you use with the rocker bottoms, are they spikeless? The few times I've picked up a spikeless shoe, they seem to be very soft, like wearing slippers. Versus the more rigid soles in traditional shoes, which I figured would be better. Which models of the New Balance and Skechers, if you know?

[Jagpilotohio]

I have a similar issue. About twice a year I will wake up and my toe feels like it's on fire and it's painful to do anything. A few days go by and I'll wake up with no pain again. It's such a weird/frustrating thing.

 

Sorry to thread jack briefly. Tmgolf, You are almost surely describing a gout attack.

 

I had my first bout of it at 30. It Tends to be hereditary. My dad had it extremely bad. I get it so badly in my big toe that I occasionally can’t walk. I’ve had it in my knee so bad that it was swollen like a grapefruit and had to be drained with a giant needle. I Needed crutches for a couple days.

 

The affected joint, most commonly it starts with the right big toe, becomes inflamed and red and feels like it’s on fire and being crushed by a vice at the same time. It usually starts while you sleep. Ankles and knees can get the gout as well, but most people get their first few bouts of it with the big toe.

 

Often there is an aggravating event such as hittting it on something or twisting It in an odd way. It usually also is accompanied by lots of drinking and eating specific gout inducing foods for a few days previous to an attack.

 

It’s caused by a build up of Uric acid in the blood. The Uric acid during an attack crystallizes in the affected joint and acts like millions of tiny razor blades. I’ve had all sorts of pain in my life, but a bad gout attack is on the top of the list of excruciating. It’s hard to even describe when it gets severe.

 

The really bad news about gout is that the only way to control it without drugs that are hard on your organs is to cut back on foods that cause it. All the good things big life. Alcohol, red meat, shellfish, legumes (beans, peanuts, peas). Anything high in purines and pyramidines. You can google it.

 

Indomethacine helps with flare ups and allopurinol is for longer term use if flare ups are quite regular. The only over the counter help is naproxen sodium (alleve).

 

Good luck with it. I hope it doesn’t get worse for you, but it usually is progressive. I had to quit drinking 8 years ago and am extremely careful with my diet and I still get an attack every couple of years.

[URStillAway]

I have the same problem with the big toe in my left foot. Very painful. Advanced osteoarthritis and the beginning of a bunion and planter fasciatis!

 

Surgery is a last resort.

 

Hopefully the acupuncture continues to help. You may have to make a regular appointment every so many weeks.

 

Wearing good shoes even when at home, orthotics, “toe stretchers”, toe exercises (as described in posts above) and regular Physio treatment helps me somewhat.

 

Good luck. I feel your pain.

 

[wmathias]

I've got Limitus in both big toes.

 

Through trial and error I've found the following things help:

 

Try all of the below, in order of importance.

 

1. Bigger shoes (esp width)

2. Reverse Morten insoles (just cut out usual insole below entire big toe)

3. Toe spacer between big toe and next one to stop your big toe turning in and becoming a bunion (this happens quickly if not addressed).

4. Wear an arch support.

 

After 6 months of the above my limitus has kind of died down and is much more comfortable.

 

Hope this helps

[ChaosTheory]

I'll have to research this Reverse Morten insole thing, since a couple of you have mentioned it.

[tarheel golf]

I know what you are going though. My orthopedic prescribed a carbon insert that was raised at the toe level. That helped but i could not bend my toes. The pain or discomfort is hard to describe. Good luck.

[hackerboy]

.... My current solution which I strongly believe to be the best is finding the right shoes. For me, slightly Wide or larger New Balance, Skechers, and Ecco are the only shoes that seem to noticeably reduce the problem. Having a rocker bottom like the former 2 is important to me. I have spent a fortune on shoes, and the right pair/fit is the best solution until they loosen up, start to bend a bit, then time for new pair/ more stability. I am not a medicine person, so the rare Aleve works wonders in stopping the inflammation short term. Unfortunately it is a progressive inexorable story/ I'm 64, hope to slow it down for the next decade. I practice a lot, but only wear my most comfortable proven sneakers for that. Thanks. And look forward to hearing others.

 

The golf shoes you use with the rocker bottoms, are they spikeless? The few times I've picked up a spikeless shoe, they seem to be very soft, like wearing slippers. Versus the more rigid soles in traditional shoes, which I figured would be better. Which models of the New Balance and Skechers, if you know?

 

New balance 2004- spikes, removable insert- I would try these to get right size and go for slightly large and wide to allow orthotic if tried.

Skechers- Pro V 3 has spikes, comfortable but run narrow- must be tried in store or other as too tight is death. Spikeless probably better for comfort with elite v3 offering extra wide which I need, and seems to change pressure points and break cycle. Ecco Biom- I love these with spikes, various models, great out of the box- vary up lacing depending on the day. Sometimes Lacing loose distally seems to take some pressure off big toe. If they get too worn in and flex too much I change them out. When I go to the range it’s mostly my Reebok walkers (which I use on daily 3 mile walks also and doesn’t seem to affect the toe anything like golf). I may test out new golf shoes at range, but for me at this stage, the walkers cause less trouble, and tend to decrease my lunging and over hitting longer clubs. So I hit hundreds of 100 yards in and save the Justin Thomas Limitus push offs for my 2-3 weekly rounds.

[Jersey golfer]

.... My current solution which I strongly believe to be the best is finding the right shoes. For me, slightly Wide or larger New Balance, Skechers, and Ecco are the only shoes that seem to noticeably reduce the problem. Having a rocker bottom like the former 2 is important to me. I have spent a fortune on shoes, and the right pair/fit is the best solution until they loosen up, start to bend a bit, then time for new pair/ more stability. I am not a medicine person, so the rare Aleve works wonders in stopping the inflammation short term. Unfortunately it is a progressive inexorable story/ I'm 64, hope to slow it down for the next decade. I practice a lot, but only wear my most comfortable proven sneakers for that. Thanks. And look forward to hearing others.

 

The golf shoes you use with the rocker bottoms, are they spikeless? The few times I've picked up a spikeless shoe, they seem to be very soft, like wearing slippers. Versus the more rigid soles in traditional shoes, which I figured would be better. Which models of the New Balance and Skechers, if you know?

 

New balance 2004- spikes, removable insert- I would try these to get right size and go for slightly large and wide to allow orthotic if tried.

Skechers- Pro V 3 has spikes, comfortable but run narrow- must be tried in store or other as too tight is death. Spikeless probably better for comfort with elite v3 offering extra wide which I need, and seems to change pressure points and break cycle. Ecco Biom- I love these with spikes, various models, great out of the box- vary up lacing depending on the day. Sometimes Lacing loose distally seems to take some pressure off big toe. If they get too worn in and flex too much I change them out. When I go to the range it's mostly my Reebok walkers (which I use on daily 3 mile walks also and doesn't seem to affect the toe anything like golf). I may test out new golf shoes at range, but for me at this stage, the walkers cause less trouble, and tend to decrease my lunging and over hitting longer clubs. So I hit hundreds of 100 yards in and save the Justin Thomas Limitus push offs for my 2-3 weekly rounds.

 

The only golf shoes I have found with adequate width and removable insoles are Footjoys. Sketchers insoles are permanently attached so they won't work with orthotics.

[nochct1]

I have a similar issue. About twice a year I will wake up and my toe feels like it's on fire and it's painful to do anything. A few days go by and I'll wake up with no pain again. It's such a weird/frustrating thing.

 

Sure you're not dealing w gout?

[GolfSchticky]

I see Hallux Limitus/Rigidus in my practice on a daily basis. I have found the best clinical outcomes by using a good rockersole shoe in conjunction with the X1 Blade for Turf Toe from www.indianabrace.com.

 

I do not suggest orthotics to my patients with this condition because I find it does not do a good enough job at limiting movement at the 1st metatarsophalangeal joint.

 

I then normally recommend a topical pain cream pre and post round. Hank Haney’s new VooDoo pain cream looks promising.

 

To get a decent rockersole shoe you may have to transition into a waterproof hiker or trail running shoe. If your course allows it.

[sigep1967]

I had something like this several years ago actually quit golfing because of it until recently picking it back up. I had huge bone spurs in the big joint on my left big toe that had to be removed. It is still stiff but relatively no pain like before. I could barely walk before the surgery to remove all the arthritis/spurs from that joint. They doc said mine was due to trauma when they asked me how many times I had broken it all I could say was no idea. I was a catcher in baseball and in my day you didn't run to the doc for everything you taped up and kept playing lol. They said that joint had been cracked/broken at least 3 times.

[Jose c.]

Been dealing with the same big right toe issues for 7yrs just turned 50. Can't put ice skates anymore,I can run but the next day I pay for it. Switched to trulinks shoes( clown shoes) for toe space also tiger woods 16 had really wide shoes.

The doctor's want to either fuse to young for that or cortozone shot. The toe spacer has been a savior the last 5yrs. You can get at CVS for a couple bucks.

[ChaosTheory]

I see Hallux Limitus/Rigidus in my practice on a daily basis. I have found the best clinical outcomes by using a good rockersole shoe in conjunction with the X1 Blade for Turf Toe from www.indianabrace.com.

 

I do not suggest orthotics to my patients with this condition because I find it does not do a good enough job at limiting movement at the 1st metatarsophalangeal joint.

 

I then normally recommend a topical pain cream pre and post round. Hank Haney’s new VooDoo pain cream looks promising.

 

To get a decent rockersole shoe you may have to transition into a waterproof hiker or trail running shoe. If your course allows it.

 

Thanks very much for the specific information. How can I identify a rocker sole? An earlier post mentioned the same with some golf shoe examples, but I couldn’t see anything unusual in the sole shapes.

[ChaosTheory]

I just ordered an X1 Blade from IndianaBrace.com. The owner is a golfer too. For me, he recommended the model that is for "Great Toe Pain/Arthritis". He says once I have it, I won't need to be looking for anything special in shoes. I hope he's right. :)

[hackerboy]

I just ordered an X1 Blade from IndianaBrace.com. The owner is a golfer too. For me, he recommended the model that is for "Great Toe Pain/Arthritis". He says once I have it, I won't need to be looking for anything special in shoes. I hope he's right. :)

 

I already responded earlier, just wanted to give you another anecdotal Limitus follow up (you can see my earlier post and suggestions). I’m currently traveling and brought a 3 year old pair of Ecco’s I haven’t worn in 2.5 years which I was going to throw out (ordered a new pair-different model-sent to final week destination). I just played 3 of the most pain-free rounds ever in the old shoes. They have a much firmer sole with little flex. This once again confirmed the critical nature of having the right shoe with the right fit being the most important anecdote. Hopefully your insert will create a similar response.

[ChaosTheory]

The Indiana guy explained to me that his insert is firm under the toe but allows the rest of the foot to move normally. And they create a rocker type movement. They are super thin so I can't imagine it's a physical rocker profile. There are youtube videos but I haven't looked for them yet.

[DavePelz4]

Had a visit with the foot doc today. Unbearable pain and some redness in the big toe joint which the internet would suggest is gout.

 

He looked at it and confirmed it was gout but the took xrays and found deterioration of the MTP joint. Some of the bone is literally gone.

 

Anyone have experience with indomethacin. Got lots of warnings from him on side effects as the same from the pharmacist.

 

I've been blessed to live pain free without any pharmaceutical help and they both concerned me.