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Winkle Picker’s Disease: Hallux Limitus and Hallux Rigidus

In England, “winkles” are a funnier, fancier word for sea snails. In order to shuck the meat, you need a pointy, skinny tool called a “winkle picker.” It wasn’t long until a new style of women’s pointy-toed shoes debuted on the scene, called winkle pickers. The rim of the front part of the shoe opened all the way until you could see the cracks of the toes, much like flats do today. The only problem? These shoes tended to rub on the joint just at the base of the big toe, creating swelling and pain for anyone who wore these styles. Thus, Winkle Picker’s Disease was dubbed. We know it more commonly today as hallux limitus or hallux rigidus.

The Condition behind the Name

The words “hallux limitus” stand for “stiff toe,” while the words “hallux rigidus” mean “rigid toe.” If your condition has progressed to the rigidus stage, you are unable to move the joint at the base of your big toe. Many people refer to this as “Turf Toe”.

When you have limited function of your big toe, this most likely occurs because of osteoarthritis, which is the “wear and tear” type of this disease. You’re most likely in the “hallux limitus” stage. You may experience pain during weight-bearing and it may also be hard to wear shoes. A deep, aching pain is typical, but it could also come on sharply. You also might feel grinding in your toe. This is because the cartilage at the base of your big toe, where your first metatarsal bone meets your toe bone, starts to break down. You might even develop a bone spur on top of the joint.

In our opinion, this is the best time get treatment from Dr. Brian McDowell and Dr. Gavin P. Ripp at the McDowell Podiatry Group. If you let it go, the condition will develop into hallux rigidus. The pain may become chronic, even with rest. This discomfort will make it hard to walk without developing knee, hip, and back problems.

Stiff Big ToeKnow What Causes a Stiff Big Toe

With the right combination of genetics, poor foot structure, or previous injury, your big toe can develop hallux limitus or, even worse, hallux rigidus. If your first metatarsal bone that connects to your big toe bone is long or elevated, you could be more at risk. In most cases, this type of foot structure is genetic.

The foot structure you most likely inherited is one that causes you to overpronate or have fallen arches, otherwise known as flat feet. Arthritis, another hereditary disease and the cause of this condition, can develop faster in people who overpronate and have flat feet. They’re susceptible to experiencing more wear and tear on their big toe joint.

Be cautious if you know foot conditions like this one run in your family. Don’t overuse the big toe joint—the wearing down of cartilage due to repetitive movements is what leads to these stiffness problems. Instead or running or walking, try more low-impact exercises like biking and swimming that take some pressure off your feet.

Injuring your foot by stubbing your toe can also create the onset, so make sure you’re watching where you walk. Conditions like gout can also create inflammatory problems that irritate the joint.

Toe Pain

Your toes undergo a lot of stress and pressure to help you balance, push off, and grip the ground as you walk, run, and go about your day. When problems like capsulitis, hallux rigidus, and claw toes kick in, we can help solve the most complex of issues.

There’s Hope for Your Toe!

We’ll try orthotics first so you put less pressure on the big toe joint. Rocker-bottom shoes would also be an easy first step to get rid of some pain. We may recommend anti-inflammatory pain relievers, too. Cortisone injections and physical therapy are some more advanced steps of treatment.

Surgery is reserved for severe cases. We’ll only recommend this treatment if we feel that it would really help your case. If it progresses to this point, we’ll consider your age, activity level, and other factors when we discuss the many options for surgery.

Sure, Winkle Picker’s Disease has a funny name, but the pain is nothing to laugh about. Please call the McDowell Podiatry Group at (916) 961-3434 to make an appointment so we can assess the severity of your hallux limitus and hallux rigidus.

Photo Credit: Hans Braxmeier

Dr. Brian McDowell
Dr. Brian McDowell, board-certified podiatrist, provides cutting-edge foot and ankle care in Carmichael, CA.