What is Trigger Toe?
Trigger Toe is much like Trigger Finger, but affects the big toe instead of one of your fingers. Trigger Toe causes the big toe to become stiff and “locked up”, so you are unable to move the toe like you should. In some cases, Trigger Toe can cause complete immobilization of the big toe.
Trigger Toe mainly affects dancers, especially ballet dancers, because of “en pointe” (standing on the toes) position and demi-pointe position. These positions put a lot of weight on the big toe, which strains the flexor hallucis longus tendon. This strain often leads to inflammation caused by overuse of the flexor hallucis longus tendon. This inflammation causes the flexor hallucis longus tendon to get “caught” inside the tendon sheath, which is what houses the tendon, causing the feeling of stiffness in the toe.
Often, the dancer will manipulate and move the toe around with their hands until the toe begins to move again. Some people with Trigger Toe will feel a clicking sensation when manipulating their big toe.
Signs & Symptoms
Signs and symptoms of Trigger Toe include:
- Inability to move the big toe (either reduced range of motion or complete inability to move the toe)
- Stiffness in the big toe
- Mild pain (may just be a feeling of discomfort)
Trigger Toe can have a devastating effect on a dancer’s career if it is not diagnosed and treated in a timely manner.
Rest, Ice, Compression and Elevation are a good first step to getting your symptoms under control. Resting will help you avoid further strain on the tendon that’s causing your toe to seize up. Applying ice and compression together will work to relieve your pain and swelling. Elevating your foot above your heart with a pillow will help to alleviate the internal inflammation.
Non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil and Aleve can be used to eliminate pain and swelling. Just make sure you only use painkillers during times of rest, because using them during physical activity can be dangerous. Painkillers mask the pain, making you unaware of any further damage you may be doing to your body when you’re active.
Exercises designed to stretch and strengthen will help you regain the proper movement of your big toe.
While surgery should be your absolute last resort, if conservative treatment methods have not helped after six months, you may want to review your options for surgery with a healthcare professional.