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Years ago I had a mountain bike accident where I smashed my big toe in a rock.
Arthritis developed, and I tried a lot of things, but it's not getting better.
climbing is painful, and I'm considering fusing the first metatarsal joint
I think I might be able to climb after that.
But I'm worried about being able to put a ski boot on.
I can live without climbing, but I couldn't without skiing.
Any advice?
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I think you’ll be fine. I don’t have a fused toe, but it’s pretty damn close and I have very little rom. Also a fused ankle. Toe is no problem getting on a ski boot (or climbing for that matter). I ski 40-50 days a year no problem.
Here’s the max range of motion for my toe.
Attachment 247371
Attachment 247372
I also have some arthritis in the toe and almost had it fused a few years ago. Met with an orthopedic surgeon who told me to change my shoes. All my shoes now have an athletic sole and I’ve really had very little pain. I’ll still get a bit of pain the day after, if I walk a lot in flip flops or something, but so far so good.
Climbing hurts thoughQuote:
Originally Posted by alias_rice
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guys I learned about this co recently that has a newer big toe joint implant that has some better outcomes- It's called cartiva
FD I have only bought the stock and am not a dr but the implant data seemed positive
it's already approved for reimbursement with a bunch insurance co's -might be something to chk out- better mobility than fusion for my ski friends!
https://www.cartiva.net/
Right, I just saw this too.Quote:
Originally Posted by b-bear
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I would only fuse as an absolute last resort. I guess it doesn't matter a *ton* for skiing because you're locked into a stiff plastic boot, but the neural link between the big toe is huge and impacts gait, balance, proprioception, etc -- the big toe even has a dedicated area of the brain (in the cortex) because proper big toe function is so important for upright bipedalism (and my understanding is no other species shares this brain circuitry).
I'm assuming you've tried PT, barefoot foot-shaped shoes, toe spreaders, etc. But have you tried PRP or stem cell injections? I'd absolutely do those first before a fusion.
There used to be a thread on EpicSki with at least a dozen people talking about that surgery and I don't remember seeing anyone who regretted getting the fusion post rehab. IIRC, there was a pretty long rehab required though, so all or part of a season would need to be sacrificed depending on when you got the surgery and how well it goes.
I have the same problem.. Big toes used to ALWAYS CRACK when taking off my boots. Right big toe has felt like it's out of joint off and on for the past 5 years, banging it the wrong way causes me so much pain I sometimes limp a little. Playing soccer got pretty challenging, but I push through the pain still. If I had the money right now I'd probably cave and go for the fusion after ski season. Right now that's not looking possible, but I know it will need to happen eventually.
I've skied for the past 5 years with a fused big toe. For me, it depends on the boot. Getting it off is tougher than putting it on, but it's not horrible. Tecnica and Lange work ok, but the way Salomons overlap make them (I tried at least 3 different models) almost impossible to put on.
Once it's in the boot, no problem.
As for the surgery ... there was no Cartiva when I did this; in fact, it was the revision for a failed implant, so I think I had no choice. It's better than it was, but it's not perfect.