How Hallux Limitus is Connected with Plantar Fasciitis



The purpose of this study was to determine the existence of limited dorsiflexion in the first metatarsophalangeal joint in patients with plantar fasciitis (PF).

Static standing foot posture and hallux dorsiflexion were measured in 100 individuals.

The Foot Posture Index was used to measure the static standing foot posture.

Hallux dorsiflexion was assessed by placing the individual in a supine decubitus position with the foot in a relaxed position and the hip and knee in neutral position.

A statistically significant difference was recorded in the hallux dorsiflexion presented by patients with PF than presented by their counterparts in the control group; it being lower in the PF group.

Excessive pronation of the foot is associated with hypermobility of the first ray due to the increased ground reaction forces on the first metatarsal and failure of the peroneus longus muscle to stabilise the first ray.

If the magnitude of the subtalar joint pronation is high, then the subsequent hallux resistance to dorsiflexion will also be high, leading to increased tension in the plantar structures and increasing the chances of developing PF.

Changes to the equilibrium between the first metatarsal structure and the ground reaction forces, causes the medial column to become unstable.

This commonly occurs in feet with either a high subtalar joint pronation moment or a reduced medial longitudinal arch.

The authors reached the conclusion that with reduced hallux dorsiflexion, there is additional tension in the plantar fascia which favours the development of PF.

Since the pronated foot was observed more in the PF group, excessive subtalar pronation may influence the etiology of PF.

References:

  1. Yolanda Aranda, Pedro V. Munuera (2014) Plantar Fasciitis and Its Relationship with Hallux Limitus. Journal of the American Podiatric Medical Association: May/June 2014, Vol. 104, No. 3, pp. 263-268

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