Hallux Limitus (Big Toe Pain) and Golf

We’re now in the heart of winter and it won’t be long until spring and the holiday season is upon us, which means it is the perfect time of year to talk about…golf??

Okay, we can hear you all the way across the internet—“Dr. Leibovitz has finally lost his mind.” 

But here’s the deal: If you’re an avid golfer who believes the sport is more than just a “good walk spoiled,” this is actually the time to address foot problems—and specifically hallux limitus.

What is hallux limitus?

Put simply, this is an especially debilitating injury that takes away your big toe’s range-of-motion. It develops over time as a bone spur builds up and enlarges the top of the joint. This spur is the result of repeated microtrauma (force that isn’t earth-shattering, but still takes its toll when experienced often).

In golf, this can happen when the big toe repeatedly endures excess force and strain while you pivot on your forefoot when swinging a club. And if your golf game is at the same level as your favorite go-to foot doc’s (which is to say, “not good”…), you are likely taking a lot of swings during the round—which increases opportunity for this injury to develop!

Hallux limitus will make you lose power on your drives and develop inconsistency in your short game because of the pain. Sound familiar? In addition to pain, you will have stiffness and restricted mobility in the big toe joint. The bone spur itself isn’t something that you will be able to feel without pressing from the outside. However, it can cause a bony bump or enlargement on the top of the toe, at the affected metatarsophalangeal joint. Your metatarsophalangeal joints are where the toes connect to your feet.

Even though the spur might not be visible to the naked eye, it is something that will typically show up in X-rays.

Calluses may develop on the side or bottom of the big toe. This symptom can be a big problem if diabetes is in the picture.

Anyone who is active might develop this condition, but it tends to be common in patients who have structural issues like flat feet or a second toe that is longer than the big toe. In terms of treatment, we may be able to address symptoms with conservative options like RICE, stretches, orthotic therapy, or even changes in footwear. Even though conservative care may relieve pain, the only way to correct this issue is with surgical intervention.

The ultimate goal of hallux limitus surgery is to increase your flexibility and range-of-motion. One thing we will not do is use any kind of artificial joint replacement. Basically, putting plastic into the body is almost never a good idea. There is simply too much risk that the plastic will break down and travel places where it isn’t intended to go. That can cause serious medical problems you’re better off avoiding.

Instead of joint replacement, we may recommend removing the bone spur buildup or fusing the joint. We can discuss this together at our office to determine what the best course of action for you and your specific treatment goals are.

If you’re an avid golfer, the time for hallux limitus surgery is in the off season! There is never a great time to have surgery but there are times that will interfere less with your game.

You may be wondering why timing is so important. Unless you travel south during the winter, you probably put your clubs in storage, right? Something that not everyone considers is the fact that there is going to be a recovery period following surgery. Depending on a variety of factors, it may take up to several months before you are able to resume normal activities, like golfing. Of course it is best to seek early intervention. You might be able to “push through” the discomfort and keep golfing with minor pain—but it will catch up at some point. Besides, you’re in pain!

Even though pain is a gift, it’s still an unpleasant experience. But it’s not one you have to live with. There are measures we can take to help you overcome painful symptoms and be able to enjoy your time on the links (instead of dreading your next swing or walking up the next hill). After all, we want you to yell “Fore!” because you’re about to hit someone with a golf ball, not because you mean “I have pain in my FOREfoot—right where the big toe connects to my foot!”

(We don’t get why you think that was a real stretch—these are some real stretches!)