Wednesday, January 21, 2015

Hallux Rigidus

Last week, after running on the treadmill at the gym, I did some lunges with my left foot on a weight bench to keep it off the ground.  I have a bad toe, and normal lunges really hurt.  But if I elevate my toe on a bench or a ball it is much, much better.  So, I was doing my elevated lunges and my foot slipped off the bench jammed my toe straight into the floor.  I almost passed out with pain. That really hurt.

I was afraid I had broken my toe.  But it didn't swell noticeably, and wasn't that bad... Five or so years ago, I went to a podiatrist who said I had arthritis in it, and it wouldn't get better, i.e., less painful.  He was right about the pain part, it has always hurt.  What is really odd is that it doesn't hurt when I run. After a run, yes.  Laying in bed, on my back, with bedcovers pushing down on my toes and feet, it is unbearable.  But running 18 miles? No.  There is some science that the stress on the big toe is less during running than in walking, so no pain during a run is not unusual.  Great, I guess.

So, I went to a new podiatrist.  Bad news: it is now advanced arthritis.  Hallux Rigidus.  And it hasn't gotten better; in fact, I now have less than 10% flexion in the joint.  And there was swelling, probably caused by my gym accident. The only real solution is to have fusion surgery, which involves opening up the toe and basically joining the toe joint and letting the bone grow so that the joint is rigid.  There is no functional loss (because the joint has no flexion now), running will be fine, and pain gone.  After all, I have less than 10% flexion now.

Except... fusion surgery entails six weeks in a non-weight bearing boot. Six weeks in a boot. Ugh. There is no good time to be in a boot for six weeks. No running (of course), but I am not worried about that as much as the sheer inconvenience of six weeks in a boot.  There is no urgency to the surgery, but I will have to get it done.  I can't have foot pain for the rest of my life.  My cynical mini plan is to wait for the next serious running injury (strained calf?  PFS?  Pulled hamstring?  Back trouble? Bueller?)  and then get the surgery done while I am otherwise out of commission with the running injury.  Kill two birds with one stone.

For now, podiatrist has given me an anti inflammatory drug, the generic version of Relafen (Nabumetone).  I am very skeptical of NSAIDs, and almost never take them.  But this drug has really, really helped.  Like wondrously so.  I left the pills at the office over the weekend and immediately regretted it.  I just wonder if the drug's side effects will affect my hydration levels and thus training (and weight).  I have looked but haven't found much science on NSAIDs effect on hydration or Nabumetone.  But it certainly cuts the pain.


  1. Have you planned out what kind of injury you would want for sure to kill two birds with one stone. I like your way of thinking. Glad that the meds can help some what. Will visit later to read your marathon report below. In the mean time, no more lunges. They are bad for you anyways.

  2. Not good, but I'd get the surgery done. A mate of mine has his ankle fused (3 pins) and has gone from painful 'limp running' to pain-free normal looking running and racing better than ever. He was in a boot too - didn't take him that long to come back.

  3. You are a runner, it is very good you do sports for healthy body and mind! :)
    Keep up!


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