For those with a painful hallux rigidus or osteoarthritis of the first metatarsophalangeal joint, dorsiflexion of that joint during gait can be painful. For that reason an often suggested treatment is to use stiffer or more rigid shoes so that the demands of dorsiflexion at that joint during gait is not as severe. Alternatively there are rigid carbon fibre plates that are usually under 1.5mm thickness that can be placed in the shoe to achieve the same thing.
Several studies have looked at the use of these. Munteanu et al (2021) showed that the carbon fibre plate inserts were more effective than sham inserts at reducing the pain in those with first metatarsophalangeal joint osteoarthritis over the twelve week follow-up. Their earlier and smaller proof-of-concept also showed they were effective at 1 and 3 months. They also showed that these carbon fibre shoe-stiffening inserts significantly altered sagittal plane lower limb joint kinematics during walking, particularly first MTP joint maximum dorsiflexion. This confirms the proposed mechanism by which these inserts can help those with first MPJ pain.
However a preliminary report from Sornsakrin et al suggested that a more flexible insole rather than the more rigid Morton’s extension plates or the Full Width Carbon Fibre Insole Plate may be more acceptable.
If the conservative measure for hallux rigidus are not helpful, there there are a number of surgical options that are available.