Massage therapy · Kitchener–WaterlooHallux Rigidus
Foot
What It Is
Hallux Rigidus Anatomy
Not a diagnosis — for more information, contact me or another trusted healthcare provider.
Treatment
Self-Care & Treatment
How to Treat Hallux Rigidus
Treatments you may want to discuss with your family doctor or nurse practitioner
Tips
- Avoid wearing shoes with a high heel, and choose shoes with a large toe box to reduce pressure on the top of the toe (AAOS, n.d.).
- Bone spurs on top of the joint can press on a small nerve, causing numbness along the inner edge of the big toe (Lam et al., 2017). Bone spurs also reduce the movement of the big toe.
- When the MTP joint can’t roll through a complete step, walking can become difficult and painful (AAOS, n.d.).
- If you are overweight, any amount of weight loss is likely to help (NICE, 2022).
- If you are having difficulty walking, see a professional who can properly diagnose your condition and discuss treatment options with you. Hallux rigidus can be easier to treat when it is recognised early (AAOS, n.d.).
Treatment
My Approach
Hallux rigidus is arthritis of the big toe joint, and it builds up over time, so I treat it as ongoing care. Exercise is the key part, with hands-on work alongside it. My aim is to ease pain, keep your big toe and foot moving, and build strength so you can walk and stay active more comfortably.
I start by assessing how far your big toe bends up and down, whether you have any numbness along its inner edge, how you roll through a step when you walk, and the strength and flexibility of your calf and foot. I'll also look at your shoes.
Hands-On Treatment
- Warm applications in the clinic, then work through the calf, shin and small muscles of the foot
- Gentle mobilisation of the big toe joint and other stiff foot joints, with no quick or forceful movements, staying within what's comfortable where bone spurs limit movement
- Light pressure over the top of the joint, where bone spurs can press on a small nerve
- If the joint is flared, cool applications in the clinic, and I'll show you how to use ice safely at home
Exercise
- Exercises to improve your big toe's range of movement, little and often
- Calf, foot and balance work, building to heel raises within a comfortable range
- Strength for the legs and hips, with gym-based progressions if you lift
- Low-impact fitness such as cycling or swimming, and a home programme between visits
Footwear
What to Expect
Typical Course
Typical course: This is a long-term condition, so care is ongoing. Most people come weekly, sometimes twice a week at first, with a reassessment at about 4 to 6 weeks, then every few weeks as you manage more on your own. Expect pain and walking to improve gradually over about 6 to 12 weeks of regular exercise and the right shoes.
What I Focus On
Gentle Big Toe Mobilisation
Range-of-Movement Exercise
Foot & Calf Release
Footwear Advice
Ongoing Self-Management
Sources
References
- American Academy of Orthopaedic Surgeons (n.d.) Hallux rigidus (stiff big toe). OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/stiff-big-toe-hallux-rigidus/ (Accessed: 7 October 2026).
- Lam, A., Chan, J.J., Surace, M.F. and Vulcano, E. (2017) 'Hallux rigidus: how do I approach it?', World Journal of Orthopedics, 8(5), pp. 364–371. doi: 10.5312/wjo.v8.i5.364
- National Institute for Health and Care Excellence (2022) Osteoarthritis in over 16s: diagnosis and management (NICE guideline NG226). Available at: https://www.nice.org.uk/guidance/ng226/chapter/Recommendations (Accessed: 8 October 2026).
- Norfolk and Norwich University Hospitals NHS Foundation Trust (2023) Big toe joint arthritis. Available at: https://www.nnuh.nhs.uk/publication/download/arthritis-of-the-big-toe-joint-hallux-rigidus-v6 (Accessed: 7 October 2026).