Q. I am a 45-year-old tennis player who has had right big toe pain for about a year. The toe also is getting stiffer and bothers me most when I serve or push off. I have tried changing tennis shoes and bought insoles but this has not helped. Is there a solution for this problem and what is my next step?
A. A condition often seen in athletes is a stiff big toe “hallux rigidis” caused by repetitive stresses resulting in a bone spur that limits motion and may cause pain. This is seen commonly in tennis, basketball and football. Motions such as jumping and pushing off tend to elicit the most pain.
Initial treatment is a custom-made orthotic to be worn in your sneakers to decrease stress on the big toe. Occasionally, anti-inflammatory medications or cortisone injections may help. Surgery to remove the bone spur may help decrease symptoms in patients who want to be active but do not respond to these conservative options. I recommend you see a foot and ankle specialist to have your big toe evaluated.
Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send questions to HarlanS@baptisthealth.net.