Big Toe Arthritis- Anyone Tele with a bone fusion

[nmaaron]

Good evening Tele folks!

Anyone have experience with hallux rigidus (big toe joint rigidity and extreme pain) where they went forward with a joint fusion? I'm putting it off due to my age (41) and the fact that I'm extremely addicted to the turn and afraid that I'll be stuck in AT stuff if anything after a fusion. The pain is getting to be way too much of a factor now though.
Anyone??

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[iBjorn]

If joint is fused, you can forget telemark. However, if it is ostheoarthritis related bone spurs that causes the rigidity, then it might be possible to remove the bone spurs and get your mobility back. You might then get 5-10 years more of telemarking, talk to an orthopedic surgeon.

[nmaaron]

If joint is fused, you can forget telemark. However, if it is ostheoarthritis related bone spurs that causes the rigidity, then it might be possible to remove the bone spurs and get your mobility back. You might then get 5-10 years more of telemarking, talk to an orthopedic surgeon.

Thanks. Yes, it's spurs and no cartilage left. My ortho recommends a cheilectomy, but as you indicate, this is good for only a few years. Another option is a joint replacement, but I'm too young for that, I am guessing. Right now, I'm in some spendy orthotics in all my boots and shoes, but I'm at the point where the pain is too much and the steroid shots ain't cutting it.

Appreciate your feedback.

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[livetogrow]

Following this thread. Hope I'm not overstepping b/c I don't telemark often, but am an avid backcountry nordic skier with hallux limitus and a doc who recommends a fusion. Granted, I don't have much flex in my toe now, but a fused joint scares me a bit, though the pain now is limiting the distance I ski and my willingness to commit to long adventures. I still get out every day or even twice if life allows, but for shorter durations. I'm 46.

[nmaaron]

Thanks for sharing. I'm also interested in learning more about anyone who does anything free heeled with a bone fusion/hallux rigidus/joint replacement. This deal really stinks!

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[Rian]

Hey all, just found your post. I'm suffering from athritis in my big toe joint too, and cant handle the thoughts of a bone fusion. I am a commited cross country skier and also touring skier and love to go over long distances. I wonder if you did a fusion yet and how this might affect our skiing techniques. Cheers

[joeatomictoad]

My big toe joint started an arthritic process started from an injury about 20 years ago, which was not properly treated. Fortunately, pain only experienced nowadays with flexion of the joint. Telemark turn puts the joint into extension, and I am lucky enough that haven't experienced pain in this motion.

Long story short, in not properly tending to the injury, I will be suffering the consequences for the remainder of my days.

[turnfarmer]

The right foot orthotic can make a huge difference in reducing the stress on the big toe joint.
The problem is almost no one makes them the right way. They need to be built like this-
https://www.vasylimedical.com/products/ ... /dananberg
The key is to reduce pressure on the first metatarsal head to unlock the big toe joint.

I also believe plastic tele boots increase the forces on the big toe. The leather boots allowed enough torsional flex that one can edge off the lateral side of the foot and the big toe did not have to dorsiflex as much as in a plastic boot.

[DiKeigley]

Tele skiing after big toe fusion is possible, yet limited. Have to say I'm just not willing to give it up yet. I primarily tele downhill at ski areas. I'm 64 and had my right big toe fused March 2019 (4 degree plate with 6 screws). I had my left big toe surgery (cheilectomy) June 2012. The cheilectomy was performed with very little to no cartilage remaining making the recovery toward a pain free joint, long and extremely painful. I got through it and after 9 years happily have limited, pain-free motion in that joint. I can address what it was like for me to recover from a cheilectomy with little to no remaining cartilage if someone wants to converse about that separate issue.

I find that I can tele for about 1/2 day but this is a reflection of my age as well as the post-fusion situation I'm in. I tele using Garmont Venus - really old boot. I've had the liner "pushed" out by a custom boot technician. That helped a lot.

I tried the NTN system for the first time last spring, SCARPA TXPRO, which I purchased during spring equipment sales for a low price tag and the fit technician melted and punched out the bellows, a controversial move. Jury's out to see if I'll be a convert to NTN. It seemed to put less stress on the fused joint than the Garmont Venus.

I bring alpine/downhill gear each day that I tele just in case I want more turns and the foot with the fused big toe joint becomes tired and irritated. Thus far, fingers crossed, the foot with the old cheilectomy doesn't give me problems. Sometimes the sesamoids become irritated which calm down over night.

I would have to say, if I were 20 years younger, I would do my best to preserve motion in the joint. Seek out physical therapy and keep manually moving the joint in ALL directions every day. There's some good posts online about big toe joint PT and movement therapies. Steroid injections don't seem to work or last. Platelet injections gave me about 6-8 years while I was putting off surgery as long as possible.

Good LUCK!

[Hhowden]

My big toe joint started an arthritic process started from an injury about 20 years ago, which was not properly treated. Fortunately, pain only experienced nowadays with flexion of the joint. Telemark turn puts the joint into extension, and I am lucky enough that haven't experienced pain in this motion.

Long story short, in not properly tending to the injury, I will be suffering the consequences for the remainder of my days.
Foot.jpg

This is great advice! I am a physical therapist assistant and my wife is a doctor of physical therapy. Toe yoga and trying to move your big toe while not moving small toes and vice versa (move just small toes together while leaving big toe stable) As well as toe crunches