A great paper on Hallux Limits

Don't let the title fool or dissuade you. 

Here is a great paper to support the post earlier this week on hallux limitus. 

Plantar pressure distribution in older people with osteoarthritis of the first metatarsophalangeal joint (hallux limitus/rigidus)

No surprise that the study found folks with osteoarthritis of the the 1st MPJ had greater maximum force and peak pressures under the hallux as well as the lesser toe than controls. 

BUT here is one of the gems from the study: " However, the plantar pressure changes observed in this study can be explained using the concept of high- and low-gear push off described by Bojson-Moller. This model suggests that there are two metatarsal axes through which propulsion may occur; a transverse axis connecting the first to second metatarsal heads, and an oblique axis connecting the second to fifth metatarsal heads. In the presence of normal first MPJ motion, a ‘‘high-gear’’ push- off occurs through the transverse metatarsal axis, resulting in an efficient transfer of bodyweight. In the presence of restricted first MPJ motion, propulsion through the transverse axis is not possible. Subsequently, a ‘‘low-gear’’ push-off occurs through the oblique axis, which subjects the lateral forefoot and toes to increased loading and results in hyperextension of the interphalangeal joint of the hallux prior to toe-off."

Zammit, G. V., Menz, H. B., Munteanu, S. E. and Landorf, K. B. (2008), Plantar pressure distribution in older people with osteoarthritis of the first metatarsophalangeal joint (hallux limitus/rigidus). J. Orthop. Res., 26: 1665–1669. doi:10.1002/jor.20700.    

link to FREE FULL TEXT: http://onlinelibrary.wiley.com/doi/10.1002/jor.20700/epdf


The Gait Guys: Some strategies in Controlling the Foot Arches and Big Toe

As promised. We fixed the volume.  Less hiss next time. Enjoy

Dr. Shawn Allen of The Gait Guys speaks about proper stabilization of the medial foot and arch. Muscle specifically discussed are a team: FHB (flexor hallucis brevis), AbDuctor hallucis, and tibialis posterior. He discusses the functional anatomy, normal and pathologic movement patterns of the arch and first ray complex and big toe (hallux). His foot’s ability to show the optimal patterns for the arch and hallux are excellent examples. Follow up videos and DVDs will show more details you need to know, and some of the exercises he and Dr. Ivo Waerlop use to restore a foot that has lost these abilities. The DVDs are in the works. Take their lectures and CME on www.onlineCE.com. Visit them at www.thegaitguys.com and on their facebook PAGE & Twitter of the same name for daily feeds of unique things.