Fusions

What is Big Toe Fusion Surgery (Hallux Rigidus)?

Hallux rigidus is a form of arthritis in the big toe joint that causes pain, stiffness, and difficulty moving the toe. Over time, the joint becomes increasingly rigid and painful, particularly during walking or pushing off the foot.

In severe cases where conservative treatments no longer help, big toe fusion surgery may be recommended.

During the surgery:

• The damaged joint surfaces are removed
• The bone at the base of the big toe is fused to the first metatarsal bone
• Screws or plates are used to hold the bones in place

This permanently eliminates movement in the joint, but it greatly reduces pain and improves stability when walking.

Although the joint no longer moves, most patients can walk comfortably again after recovery.

How Does Hallux Rigidus Develop?

Hallux rigidus develops due to degeneration of the cartilage in the big toe joint.

Common causes include:

• Arthritis of the big toe joint
• Repetitive stress on the foot
• Previous toe injuries
• Structural foot abnormalities
• Genetic predisposition

The condition gradually worsens over time and can cause significant pain when walking or standing.

What Are the Symptoms of Hallux Rigidus?

Symptoms usually develop gradually and worsen over time.

Common symptoms include:

• Pain in the big toe joint when walking
• Stiffness in the big toe
• Difficulty bending the toe upward
• Swelling around the joint
• Pain that worsens in cold weather
• Difficulty wearing certain shoes
• Reduced push-off strength when walking

In advanced cases, bone spurs may form around the joint, further limiting movement.

What Should I Do If I Have Severe Big Toe Arthritis?

If you have persistent big toe joint pain or stiffness, you should seek medical assessment.

Early treatment may include:

• Activity modification
• Footwear changes
• Orthotics or insoles
• Physiotherapy
• Anti-inflammatory medication

If symptoms continue despite conservative treatment, fusion surgery may be recommended.

Physiotherapy Treatment After Big Toe Fusion Surgery

Physiotherapy plays an important role in recovery after big toe fusion surgery, even though the joint itself no longer moves.

At ACE Physio Sports in Singapore, physiotherapists provide personalised rehabilitation programmes to help restore mobility and walking function.

0–6 Weeks After Surgery

During the first phase of recovery, the foot must be protected while the bones fuse together.

Patients typically wear a surgical boot for around six weeks.

Physiotherapy during this stage focuses on:

• Swelling management with ice therapy
• Elevating the foot to reduce inflammation
• Gentle exercises for other joints in the foot and ankle
• Maintaining strength and circulation in the leg
• Preserving overall fitness with safe exercises

6–12 Weeks After Surgery

Once the surgical boot is removed, physiotherapy focuses on restoring normal walking patterns.

Treatment may include:

• Gait retraining to improve walking mechanics
• Balance and stability exercises
• Gradual return to everyday activities
• Functional training such as stair climbing
• Exercises to adapt to the fused joint

Because the big toe no longer bends, the body must learn new walking mechanics.

12 Weeks and Beyond

Later rehabilitation focuses on returning to normal activity levels and recreational activities.

Physiotherapy may include:

• Strengthening exercises for the foot and lower leg
• Advanced balance training
• Walking and endurance exercises
• Gradual return to sport or recreational activities

Most patients return to normal activities within 3–6 months.

What Should I Avoid After Big Toe Fusion Surgery?

During recovery, it is important to protect the fused joint.

Patients should avoid:

• High-impact activities early in recovery
• Walking without protective footwear too soon
• Running or jumping before healing is complete
• Tight shoes that place pressure on the big toe

Following physiotherapy guidance helps ensure proper healing.

Can There Be Long-Term Effects?

Big toe fusion surgery is generally very successful for relieving pain caused by severe arthritis.

Possible long-term considerations include:

• Loss of movement in the big toe joint
• Changes in walking mechanics
• Mild stiffness in surrounding joints

However, most patients experience significant pain relief and improved walking ability after recovery.

Why Choose ACE Physio Sports

At ACE Physio Sports – Singapore, our physiotherapists specialise in foot and ankle rehabilitation, sports injuries, and post-surgical physiotherapy.

Our clinic provides:

• Experienced musculoskeletal physiotherapists
• Personalised rehabilitation programmes
• Evidence-based physiotherapy treatments
• Structured recovery plans following foot surgery

Conveniently located near East Coast Road, we treat patients from Marine Parade, Katong, Joo Chiat, Siglap, and Bedok.

Book an Appointment

To arrange an appointment, please call +65 81535374 or visit acephysiosport.com