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Does any member have suggestions regards to off loading 1st mtp, I fear the joint has subluxed and would probably require reconstructive surgery, however the subject is a poor candidate for any procedure due to ill health and limited in taking good effective pain relief. The lesser toes are hammer type and she has very tight TA and weak peroneii, tib post / ant. I have advised to stretch and strengthen appropriate tissues, and I have trialled some taping to achieving as near to neutral joint position which helps while tape is in-situ. Orthotics and pads have been unsuccessful. Any comments appreciated, Guy

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Perhaps you could look at a rockerbottom sole for one pair of shoes to help with propulsion ? If this helps you could always do other footwear.

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Can we get a link to the how to present a patient thread?

Presenting Patients for Clinical Advice.

I`ve said this before; IMO, `how to present a patient` should be on the Homepage....In BOLD!

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I had a pt who presented with less acute symptoms recently but 1st MTPJ pain none the less. She obtained a small amount of relief thorough wearing runners full time as opposed to court shoes, however all attempts to increase MTPJ function causes more pain. During gait she shows huge amounts of forefoot abduction to avoid hallux dorsiflexion at toe off.

In my most recent consult with her I recommended she trial a rocker-bottom style shoe to minimise hallux dorsiflexion at toe off. I've not had a follow up at this point but I'll had something after I've seen her next week.

Hi There

Might be worth trialling low shore cuctom tcis with shaped pad with 1st MPJ soft cut out, to try offload the painfull area on walking gait