Turf toe/ hallux limitus/ big toe arthritis and golf

[Justsomeguy]

Use the info and avoid purines and aspirin. Stick it out for 2 weeks and reevaluate.

[ChaosTheory]

I have now used the X1 Blade insert from Indiana Brace for a couple of riding 18's, couple of range sessions, and a walking 9. It is helping a lot. It should eliminate the ordeal of looking for special shoes IMO. But even though it is only about the thickness of 2 or 3 business cards, it does take up a noticeable space in the shoe by virtue of its built in rocker curve. It flexes of course, but the curve still wants to be there. So I'm planning on buying a roomier pair of shoes, which were probably needed in any case.

 

If you buy one, you have to talk to the company owner, who I think is some sort of practitioner, and a golfer. He will ask you about your problem and recommend the exact model. And will try to get your size nailed down based on the shoe brand and size you use. It's not cheap but it's very promising for me.

[DavePelz4]

Two weeks into things and it's been interesting. The blood chemistry found absolutely nothing out of the ordinary and only the recommendation was to add things back into the diet one at a time to see if there is a trigger. So far, the only trigger has been watching Roy Rodgers re-runs. Had 2 beers on Saturday...no response.

 

Walked 72 holes this weekend with 2 different shoe sizes and that's worked well. Have iced it down post round and wore a corrective device for the toe overnight. Not sure where this is going but it's a helluva lot better than it was.

[Justsomeguy]

Two weeks into things and it's been interesting. The blood chemistry found absolutely nothing out of the ordinary and only the recommendation was to add things back into the diet one at a time to see if there is a trigger. So far, the only trigger has been watching Roy Rodgers re-runs. Had 2 beers on Saturday...no response.

 

Walked 72 holes this weekend with 2 different shoe sizes and that's worked well. Have iced it down post round and wore a corrective device for the toe overnight. Not sure where this is going but it's a helluva lot better than it was.

2 different size shoes sounds like the ticket.

Side note - I've got the bad big toe in the same foot as plantar fasciitis, and I recently picked up some freezy socks - basically ice packs built into socks - and they work absolutely awesome.

[ChaosTheory]

OP here. Still hurting and still trying to solve it. Thought I’d bump to get more thoughts.

[ChaosTheory]

I want to report on what has and has not helped.

 

Soft comfy shoes, such as Ecco Biom Hybrid 3, do not help. My toe is more aggravated by the golf swing than by walking. Although walking by itself can contribute to the problem, and walking golf is a double whammy. To fix it, I need stiff soles, to minimize the bending and stress on the right big toe during the swing.

 

I don't think there is a pair of golf shoes made that is going to be stiff enough to do what I am looking for.

 

I tried a pair of stiff soled hiking boots, and they worked. My toe was not aggravated by walking golf. But they don't fit me right, so I need to find another brand. Still, this is the most promising thing I can report.

 

Based on how various sneakers of mine work or don't work for non-golf walking, I am going to try a running shoe with a rocker sole. Hoka brand, probably. They offer two different types of rocker. One they call early stage rocker, and the other is late stage rocker. Based on my reading, the early stage is more appropriate for people with toe problems. It puts the pivot point rearward of the toe. But I am going to try both styles in the store and make an educated guess. They are fairly hideous to wear on a course, and not waterproof, but we'll see. Plus, I think they will still let the toe flex too much during the swing.

 

Whatever I wear for walking always needs better arch support. I've been using felt pads made for the purpose, and the better ones let you peel off layers of felt to get the lift to be just right. I've saved a few pairs of street shoes this way. I'm also going to experiment with Sole brand insoles to get the right arch support without adding heel lift. The other brands I've looked into caused the heel to be higher inside the shoe, which never goes well for me.

 

Based on searches here, I think this problem affects a good number of golfers, and I am a little surprised some company is not offering a shoe for it. Even if it was $200 or more, if it truly worked, I'm in.

 

Oh, edit to add: The thin graphite inserts from Indiana Brace Co. didn't work, but I have not quite figured out why. Possibly I need to add arch support. Maybe they kept the toe from bending, but it still wasn't properly supported. Also, they were cutting into the inside of my shoe. I might have to trim them. This will all be looked at this spring when I am back in Illinois.

[Justsomeguy]

I went back to a different pair of sneakers, and everything cooled off to normal base levels of pain, no longer super pain.

NB tennies caused the flare up.

Went back to Asics Kayanos, back to normal.

They're basically running shoes for chubby people, amazing padding, good toe box.

Takeaway: try completely different footwear. Whatever you use now, ditch it, and give something else a shot for a couple months.

[BB28403]

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.

 

You lost me at Hank Haney! Haha

 

Maybe go see a Rheumatologist? They specialize in arthritis. But yeah prob not too much anyone can do for you.

 

I would try Osteo Bi Flex, it actually helps.

[ChaosTheory]

I bought some hiking shoes and they are working well so far. I've walked nine, and also eighteen with them. The salesguy at REI said these were the stiffest of the low cut shoes they had in the store. Also, they have rocker just behind the toe joints, so that your foot can rock without a lot of toe bend. The insole they come with is much like a premium one, with a firm arch support. So that's a money saver, for me anyway. Traction during a swing on wet grass is not as good as spiked shoes. Otherwise probably similar to most spikeless ones.

 

I had to buy a Wide (normally I'm a medium). They are not cheap, but hey, so far, so good. :)

 

https://www.rei.com/...king-shoes-mens

[ALIF]

OP here. Still hurting and still trying to solve it. Thought I’d bump to get more thoughts.

 

Not trying to minimize your problem but what’s the big deal? Either have a fusion of your big toe joint or an implant. I’ve heard the double stem silastic ones are very reliable with a low revision rate if you want an implant. Heck, Tiger Woods had a L5-S1 spinal fusion and he’s a PGA tour winner again. Old guys get total knee and hip implants all the time. The great toe joint is not even a real weight-bearing joint. It’s just a hinge joint. You could have the implant put in and would most likely be very very satisfied with it. For some reason if it failed, you could still have a fusion surgery performed successfully. Good luck with your problem and I hope it gets resolved in a manner that is favorable to you.

[deaddog]

I've been dealing with HR in both big toes for almost 20 years. The guys pushing rocker soles have the right idea. The X1 brace works ok in protecting the toe but is generally uncomfortable throughout the length of my foot after walking 18. The key is to find a good pedorthist, take him/her your favorite golf shoes (wide toe box is key to avoid compressing those bone spurs) and have him/her pull off the sole and add a rocker precisely where you need it (generally a function of examination /measurement). Makes walking 18 very doable for me when it would be literally impossible in regular golf shoes. Its not cheap (about 150 a pair + cost of shoes, of course) but well worth it. Make sure its a pedorthist, not just a shoemaker -- the placement of the rocker is key.

[ChaosTheory]

Thanks deaddog. I had no idea this was possible. I can report that my Oboz hikers continue to do very well for me. But I'd like a golf shoe if I can get it. I'll see if there is a pedorthist in the Chicago area.

 

The X1 Blade has been a disappointment for me. I think it needs to be stiffer in the toe zone, for one thing.

[martynbirch]

> @Snowman9000 said:

> OP here. Still hurting and still trying to solve it. Thought I’d bump to get more thoughts.

 

The fusion op I had and mentioned earlier maybe as some state a last resort and is irreversible but if it works then surely worth considering. I walked 18 3 days in a row last week with no problem at all.

 

[ChaosTheory]

marty, thanks. I am not bad enough yet. I still have some hope that I might be able to find a way to cope with it if I take better care of things.

[tarheel golf]

I know you pain. Left big toe. Went the surgery route. Cleaned up some debris and added a screw for stabilization. Non weight bearing for 5 weeks. Better, but still have some strange sensations. Usually walk when I play. Found that the New Balance and Addias 360 worked the best.

[JerseyShore]

I see this thread appears to have gone silent. But, I just came across it and I am sitting here two weeks post op for the fusion of my right big toe and wanted to weigh in. I was a field goal kicker from middle school through college - straight on with a square toe kicking shoe. Repeatedly broke my toe and played through it. Now that I’m 59, the arthritis in my big toe became too painful to ignore any longer. The big concern I had going in to the surgery was how long before I can golf again and will I be able to finish on my right toe. For those considering fusion, I was told that it would be 4-6 months before I can play again but that the golf follow through ending on the right toe should be ok. Like others here on this thread, I have ordered the X1 blade shoe insert. I plan to wear it in my right golf shoe when I start playing again. I also plan to wear Sqairz golf shoes for the bigger toe box and because they have a rigid sole. The hardest part of the surgery is the 3 weeks of no weight bearing. I had forgotten what a pain in the *** it is to get around on crutches. If you have stairs or a sunken family room - they present real difficulties. Post surgery pain was not that bad and weaned myself off the pain meds after several days. 

[rwc356]

@JerseyShore hope the rehab goes well. Interested to see how the shoe insert and bigger toe box works out for you. I've been battling arthritis pain in both feet for many years (too many years officiating football just wore down the feet) - orthotics and pain meds make it bearable but always open to new ideas.

[ChaosTheory]

On 2/21/2021 at 6:49 AM, JerseyShore said:

I see this thread appears to have gone silent. But, I just came across it and I am sitting here two weeks post op for the fusion of my right big toe and wanted to weigh in. I was a field goal kicker from middle school through college - straight on with a square toe kicking shoe. Repeatedly broke my toe and played through it. Now that I’m 59, the arthritis in my big toe became too painful to ignore any longer. The big concern I had going in to the surgery was how long before I can golf again and will I be able to finish on my right toe. For those considering fusion, I was told that it would be 4-6 months before I can play again but that the golf follow through ending on the right toe should be ok. Like others here on this thread, I have ordered the X1 blade shoe insert. I plan to wear it in my right golf shoe when I start playing again. I also plan to wear Sqairz golf shoes for the bigger toe box and because they have a rigid sole. The hardest part of the surgery is the 3 weeks of no weight bearing. I had forgotten what a pain in the *** it is to get around on crutches. If you have stairs or a sunken family room - they present real difficulties. Post surgery pain was not that bad and weaned myself off the pain meds after several days. 

 

How did the recovery go?  I think I'll have to get it some day.

[DavePelz4]

2 hours ago, Snowman9000 said:

 

How did the recovery go?  I think I'll have to get it some day.

 

Equally interested. Injured the left toe which was already bad, in a fall and it was several painful weeks. Have been told I need to have the joint infused but once done/recovered, the foot will be pain free.  As someone who walks every round, it's been tough to ride as that's just not my favorite way to traverse the golf course.

[Mustard_Tiger]

Snowman -

 

I'm assuming you've at had x-rays of the troublesome toe? (or perhaps an MRI)  Is there an explanation for your pain? Bone growths? Deterioration of the cartilage?

 

I had problems with my right big toe about 7 years ago. In 2017 I went to see a podiatrist and an x-ray showed I had a bone growth in my big toe joint like the image below.

 

 

I had a cheilectomy done which opened the joint and ground off the offending bone growths. Thankfully my cartilage was in decent shape. I'm now 3.5 years post surgery and am pain free and have a much greater degree of flexibility in the joint. Using splits or rocker soles would have lessened the pain but it would have done nothing to correct the actual problem.

 

I will also add that as of 2017 my podiatrist said that the joint replacement technology for the big toe joint was terrible and absolutely not a realistic option. I don't know what advancements have been made since then.

 

Fusion should be an absolute last resort. I cringe when I hear people suggest it (not to say it's never warranted).

Edited May 25, 2021 by Mustard_Tiger

[DavePelz4]

25 minutes ago, Mustard_Tiger said:

Snowman -

 

I'm assuming you've at had x-rays of the troublesome toe? (or perhaps an MRI)  Is there an explanation for your pain? Bone growths? Deterioration of the cartilage?

 

I had problems with my right big toe about 7 years ago. In 2017 I went to see a podiatrist and an x-ray showed I had a bone growth in my big toe joint like the image below.

 

 

I had a cheilectomy done which opened the joint and ground off the offending bone growths. Thankfully my cartilage was in decent shape. I'm now 3.5 years post surgery and am pain free and have a much greater degree of flexibility in the joint. Using splits or rocker soles would have lessened the pain but it would have done nothing to correct the actual problem.

 

I will also add that as of 2017 my podiatrist said that the joint replacement technology for the big toe joint was terrible and absolutely not a realistic option. I don't know what advancements have been made since then.

 

Fusion should be an absolute last resort. I cringe when I hear people suggest it (not to say it's never warranted).

 

Very interesting comment on the joint replacement .  One of my very good, non-golfing friends had his left big toe joint replaced about a month ago. He said the surgery took less than an hour, he did some minor walking that day, was limited in movement for 2 weeks and after 3 weeks he was walking with full movement and no pain. He swears this was a great way to go for him.

[ChaosTheory]

53 minutes ago, Mustard_Tiger said:

 

Fusion should be an absolute last resort. I cringe when I hear people suggest it (not to say it's never warranted).

 

Yes, I've had X-Rays.  It's basically bone growth from arthritis.  My foot doc does some teaching of surgery so he is considered pretty good in a small market way.  He was advocating some reconstruction involving shortening of a bone or two, but others have said the fusion has the best success rate.  In any event, getting custom golf shoes from Larosa Shoe Repair across from the Footjoy factory has made all the difference in the world.  If only I had gotten them two or three years earlier, I would probably have quite a bit less going on with my toe.  With them, I play with no pain, and I can walk if I want to.  The next day I will have a bit of soreness but nothing like before. 

 

My foot doc told me what to ask for when I was looking for a shoe guy to modify something for me.  I looked all over Chicagoland and found no one who could understand what I needed.  Someone here pointed me to Larosa.   Even just doing it over the phone, it came out great.

 

 

[Mustard_Tiger]

48 minutes ago, DavePelz4 said:

 

Very interesting comment on the joint replacement .  One of my very good, non-golfing friends had his left big toe joint replaced about a month ago. He said the surgery took less than an hour, he did some minor walking that day, was limited in movement for 2 weeks and after 3 weeks he was walking with full movement and no pain. He swears this was a great way to go for him.

 

 

I hope things have gotten more advanced. While a cheilectomy has fixed my problem for now, I'm sure my toe will worsen over time as I'm 50. It would be nice to have joint replacement as an option in the future. I do not want to go the route of fusion because I'm very active and while fusion solves the immediate pain problem, it creates issues up the foot, ankle, and leg as time goes on.

Edited May 25, 2021 by Mustard_Tiger

[JerseyShore]

Well, I’m now 4 months post-op from the fusion surgery. Did not expect as long and as difficult a recovery. My foot is still too swollen to fit in a normal shoe. It still feels like I’m walking on a bag of water. I have 5 screws and a plate in there.

 I typically wear a 9.5 medium. I have purchased a couple of pairs of Footjoy Hyperflex soft spikes and wear them every day as my “sneakers”. I purchased one pair in 9.5 wide (E), and it was kind of tight. So I bought two more in 9.5 extra wide (EE). That size works for me. However, because they screw your toe pointing up slightly, your toe presses against the top of any shoe. This makes wearing a carbon fiber inserts too painful.

I have a mat and a net in my backyard. This week, I started doing half swings and full swings by stepping through -scared to death of putting weight on the toe just yet.

Your experience may vary, but mine has been that recovery time will likely be 6-12 months.

[ChaosTheory]

1 hour ago, JerseyShore said:

Well, I’m now 4 months post-op from the fusion surgery. Did not expect as long and as difficult a recovery. My foot is still too swollen to fit in a normal shoe. It still feels like I’m walking on a bag of water. I have 5 screws and a plate in there.

 I typically wear a 9.5 medium. I have purchased a couple of pairs of Footjoy Hyperflex soft spikes and wear them every day as my “sneakers”. I purchased one pair in 9.5 wide (E), and it was kind of tight. So I bought two more in 9.5 extra wide (EE). That size works for me. However, because they screw your toe pointing up slightly, your toe presses against the top of any shoe. This makes wearing a carbon fiber inserts too painful.

I have a mat and a net in my backyard. This week, I started doing half swings and full swings by stepping through -scared to death of putting weight on the toe just yet.

Your experience may vary, but mine has been that recovery time will likely be 6-12 months.

I gathered as much somewhere.  That is tough.  Thanks for the update.  Good luck and feel good soon!  

[JerseyShore]

For those thinking about fusion surgery, I'm now about six months out from the fusion surgery on my right big toe. The swelling has come down quite a bit in the last few weeks. I have started playing golf with my regular foursome. I am still doing a Gary Player step through move rather than finishing on my toe. Although the swelling has come down - there is still some residual swelling that prevents me from wearing narrow shoes and the toe still presses against the top of the shoe which, depending on the particular shoe, can be quite uncomfortable and downright painful. Because of the residual swelling and a numb feeling in my foot, I am not ready to walk the course.  Because the toe still points upward, my gait has changed - I don't walk normally because the toe does not come down with each step. I am told that over time, it will come back down to a more "normal" position. I am seeing slow, steady progress and am happy to be playing again.

So, my personal experience has been that it took about 5 months before I could start playing again. And, I am guessing it is going to take close to a year before the residual swelling and numbness completely resolve.

I sought out the surgery because I was in pain each time I played. Was it worth it? At this point, I can't say. Once the swelling is all gone and I can get back to a more normal gait and golf swing, I may feel much differently. But, for now, it has been a longer and more uncomfortable process than I anticipated. Your experience may vary.

 

[ChaosTheory]

9 hours ago, JerseyShore said:

For those thinking about fusion surgery, I'm now about six months out from the fusion surgery on my right big toe. The swelling has come down quite a bit in the last few weeks. I have started playing golf with my regular foursome. I am still doing a Gary Player step through move rather than finishing on my toe. Although the swelling has come down - there is still some residual swelling that prevents me from wearing narrow shoes and the toe still presses against the top of the shoe which, depending on the particular shoe, can be quite uncomfortable and downright painful. Because of the residual swelling and a numb feeling in my foot, I am not ready to walk the course.  Because the toe still points upward, my gait has changed - I don't walk normally because the toe does not come down with each step. I am told that over time, it will come back down to a more "normal" position. I am seeing slow, steady progress and am happy to be playing again.

So, my personal experience has been that it took about 5 months before I could start playing again. And, I am guessing it is going to take close to a year before the residual swelling and numbness completely resolve.

I sought out the surgery because I was in pain each time I played. Was it worth it? At this point, I can't say. Once the swelling is all gone and I can get back to a more normal gait and golf swing, I may feel much differently. But, for now, it has been a longer and more uncomfortable process than I anticipated. Your experience may vary.

 

Thank you for the info.  Please update when you have gotten to the end of it.  

[Tanner25]

On 7/23/2021 at 9:41 PM, Snowman9000 said:

Thank you for the info.  Please update when you have gotten to the end of it.  

Hi Snowman9000, What is the latest on your big toe? I was just diagnosed with arthritis on my big toe and had an inflection on top of it. The inflection should clear with antibiotics. Now, I'm trying to figure out how to play comfortably on this painful big toe (trail side). 

[ChaosTheory]

2 hours ago, Tanner25 said:

Hi Snowman9000, What is the latest on your big toe? I was just diagnosed with arthritis on my big toe and had an inflection on top of it. The inflection should clear with antibiotics. Now, I'm trying to figure out how to play comfortably on this painful big toe (trail side). 

I’m doing pretty well by using golf shoes modified to protect the joint.  If I didn’t golf, I don’t think the problem would have amounted to much to begin with.  Here is a link to a write up.  I’ll add that I am finding that I do better with a roomier toe box than the footjoys have.  I just had Larossa stretch them so we’ll see.  He did a pair of New Balance golf shoes for me too.  I’ve been wearing those for every round because of the roomy toe box, and my toe comes out in good shape.  Here’s the other post:

coming…

Well I’m having a heck of a time getting the other post put in here.  Okay it’s in the next post. 

Edited February 6, 2022 by Snowman9000

[ChaosTheory]