#421 Can I do calf raises with hallux rigidus? - DOC

#421 Can I do calf raises with hallux rigidus?

Can I do calf raises with hallux rigidus? Well, that’s what we’re talking about today on the Doc On The Run Podcast.


Today’s episode actually comes from a question from one of the YouTube viewers, and this was a great question. He wanted to know whether or not he could do calf raises if he has hallux rigidus and he’s had pain in the big toe joint, and he wants to make sure that condition does not get worse. That is a great question.

The whole name of the game with hallux rigidus if you’re a runner is to make sure that you don’t wear out the joint prematurely. If you think of the joint as a wear item like a tire on a car, you want to be careful with it. You don’t want to wear it out because you can’t just go get another one at the shop. And with tires, it’s really simple, if you’re not going really fast around corners, if you’re not breaking too hard, if you don’t accelerate too hard, the tires last a lot longer.

You have a similar thing that happens with a joint. If you have a limitation of motion in the big toe joint, which we as doctors call hallux limitus or hallux rigidus, well, that means that the joint is actually jamming when you bend it upward too far. And so this was a great question. This runner wanted to know whether or not it was safe to do calf raises.

So we all know that if you’re doing calf raises, if you’re standing there, if you add additional weight and then you stand up on your toes with your heels off of the ground, well, that fires the calf muscle to pull your Achilles tendon and pull on the heel bone and pull your heel up off the ground. And that’s a good way to bring some calf specific strength into your overall running fitness.

Now, the problem is that when you’re standing up on your toes, you’re bending the big toe joint. If you’re all the way up on your toes doing calf raises, it’s getting to the end range of motion where you might be jamming the joint and could cause trouble. In addition, if you’re holding weight while you’re doing that, like a barbell or a couple of dumbbells, the more weight you have, the more unstable you might be and the more you might wobble from side to side and in a way actually load that joint and tweak it or compress it in a way that could be damaging to the cartilage and then prematurely accelerate the arthritis in the joint. 

You don’t want to do that. So the short answer is, if you’re doing calf raises the normal way where you just stand up on flat ground and then pick up some weight and stand up on your toes, that’s a bit risky.

Now, there is a way you can do it and modify the activity a little bit so that you can do some calf raises, build some calf specific strength, but maybe not put the joint at risk. So if you think about eccentric heel drops or egocentric calf stretches, what you do is you put your feet on the edge of a step, and then you just slowly lower down so that your heel is actually below the step. And then, of course, you start to stand up on your toes from there and when you rise back up and pull the heel back up to where it’s level with the step you’re standing on, well, your foot’s flat at that point.

Now, if you continue going upwards so you’re all the way up on your toes, you’re now back in the scenario we were just talking about that could actually jam and compress the cartilage in the big toe joint. So you don’t want to do that.

So basically, to do calf raises when you have hallux rigidus and you don’t want to get to that end range of motion, well, you stand on a step, you drop your heel down so that your toes in the ball of the foot is still on the step. You just lower your heel down below the step and then use your calf muscle to pull you back up to about level, and with your foot at about level, well, you’re not really going to jam the joint.

That’s a way to do it that’s very low risk to keep the foot flat, not jam the joint, and not really a risk of accelerating the arthritis in the big toe joint. So great question. I think that really is something that I’ve never thought about, but it makes total sense that this runner watching one of the YouTube videos was concerned about it and hopefully it’ll help you too. But just make sure you’re doing everything you can to avoid jamming the big toe joints when you’re a runner with hallux rigidus and you’ll be able to run a whole lot longer.