painful hallux after prolonged walking

[angelamfoster]

I am a walker who regularly walks 10 - 13 miles. I suffer from hallux abductovalugus. I use vasyli danenburg insoles in my salomon mid hi boots. After about 8 miles by great toe fires.I apologise about the advertising , but should let me know what I am wearing.Should I support and offload the roll of the hallux to prevent the pain or should I remove the lower layer part of the insole of the ist ray.which is what the insole was designed to do. I have limited dorsiflexion, but removing the lower layer seems to increase the pain in the short term and I am nervous to try this out on a regular walk.That is just the left foot. The right is not so bad and 4th ray problems seem to have been helped by a met raise. Thats not bad for a pod's foot ' (is it!!!
Thanks for any advice - what is that physician heal thyself -
Angela

[Admin]

angelamfoster said:

I apologise about the advertising

Hi Angela,

That's info rather than advertising, so OK .

I think the solution to your problem really depends upon how severre the HAV actually is.

Mild HAV can be helped considerably by the right orthosis (I recommend custom, by someone who knows what they're doing). Severe HAV is really only helped (in terms of allowing normal function without pain - normal in this case being the ability to walk a good few miles at any one time) by surgery (again, by someone who knows what they're doing).

Regards,

david.

[robertisaacs]

Hey angela

Bit more info would be handy. I'll admit to some confusion.

After about 8 miles by great toe fires

Eh?

Should I support and offload the roll of the hallux

Double eh?

should I remove the lower layer part of the insole of the ist ray.

You mean remove something from under the met head to increase 1st met dorsi?

Some other info which might help.
What is your 1st mpj range?
What is your ankle range?
What is your STJ function like?
How much 1st met dorsi does it take on Weight bearing before plantar fascial tension kicks in (jacks test)

Much ta
Robert

[Admin]

Hi Robert and Angela,

Angela, I presumed (always a dangerous thing to do ) that your walking is carried out on undulating surfaces. Could you also confirm/deny this?

Cheers,

David

[angelamfoster]

You mean remove something from under the met head to increase 1st met dorsi?

Some other info which might help.
What is your 1st mpj range?
What is your ankle range?
What is your STJ function like?
How much 1st met dorsi does it take on Weight bearing before plantar fascial tension kicks in (jacks test)

The terrain is undulating, certainly and the pain is worse coming down hill. The joint first gets hot and then the pain is like a red hot poker. I have an assessment on my feet and if I can remember it appears just before toe off the mpj appears almost unstable and plantarflexes, causing marked pronation. This is why i thought that supporting the joint would stop the roll and allow the momentum to be directed into toe off instead of having to stabilise before toe off.The joints are mobile, as are most of my joints, though more plantar flexion than dorsiflexion. Ankle range good, weak right after an ankle injury, though the mid hi boots support well. I am 51, if that helps. STJ quite good.I do pronate and use 4 degree insoles.Slight spread between 3rd and 4th toes, helped by met pads.Jacks test - difficult on yourself , but appears that jacks test indicates no problem. More pain in 2nd proximal joint at that point.

[angelamfoster]

I forgot the danenburgs allow distal and proximal pads on the lower layer of the insole to be removed under the MPJ to allow full range of plantarflexion available to be utilised

[davidsmith]

Dear Angela

Are you a podiatrist or some other health professional or a layperson.

If you are a podiatrist then I cannot understand your terminology or any concept you are trying to convey.

If you wish to get a sensible answer you need to use standard teminology, explain more thoroughly and not use abbreviated sentences. EG "STJ quite good" means nothing.

If you are a lay person explain in your own words it will probably make more sense.

Dave Smith