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Can A Reverse Morton’s Extension Be Beneficial For Treating Functional Hallux Limitus?

Jenny L Sanders DPM

Functional hallux limitus is a loss of metatarsophalangeal joint (MPJ) extension during the second half of the single support phase when the weightbearing foot is in maximal dorsiflexion. Functionally, it constitutes a sagittal plane blockade during gait. As a result, the mechanical support and stability mechanisms of the foot are disrupted with important consequences during gait.1

Compensation mechanisms related to hallux limitus may include lateral deviation of the center of pressure, increased pronation at the midtarsal and subtalar joints, abductory twist, early heel off, and a lack of full hip and knee extension.2 Foot symptoms related to functional hallux limitus include first MPJ dorsal exostosis, lesser metatarsal overload, neuroma exacerbation, pinch callus/tyloma and hallux nail changes.

The following video provides an overview of assessing functional hallux limitus clinically as well as treating the condition utilizing a simple reverse Morton’s extension. One can use a reverse Morton’s extension alone or in combination with custom functional orthoses. Watch the video at https://www.youtube.com/watch?feature=player_detailpage&v=rHigYAhRg_g .

References

1. Vallotton J, Echeverri S, Dobbelaere-Nicolas V. Functional hallux limitus or rigidus caused by a tenodesis effect at the retrotalar pulley: description of the functional stretch test and the simple hoover cord maneuver that releases this tenodesis. J Am Podiatr Med Assoc. 2010; 100(3): 220-9.

2. Dananberg HJ. Functional hallux limitus and its relationship to gait efficiency. J Am Podiatr Med Assoc. 1986; 76(11):648-52.