Study Design: Clinical trial. Objective: To determine the effect of 2 conservative intervention approaches for functional hallux limitus. Background: Metatarsophalangeal joint (MPJ) sprains are common and can result in long-term sequelae such as persistent pain and loss of range of motion (ROM) secondary to bony proliferation and articular degeneration. It is important to determine the most effective intervention for functional hallux limitus to decrease pain and restore function. Methods and Measures: Twenty individuals with first MPJ pain, loss of motion, and weakness participated in the study. All patients received whirlpool, ultrasound, first MPJ mobilizations, calf and hamstring stretching, marble pick-up exercise, cold packs, and electrical stimulation. Ten of the 20 patients (experimental group) also received sesamoid mobilizations, flexor hallucis strengthening exercises, and gait training. Treatment was provided 3 times a week for 4 weeks. Measurements of first MPJ extension ROM, flexor hallucis strength, and subjective pain level were performed on the first and last visits. Results: Following the 12 therapy sessions, the experimental group achieved significantly greater MPJ extension ROM and flexor hallucis strength and had significantly lower pain levels as compared to the control group (P<.001). Conclusions: These results suggest that sesamoid mobilization, flexor hallucis strengthening, and gait training should be included in the plan of care when treating an individual with functional hallux limitus.

J Orthop Sports Phys Ther. 2004;34(7):368-376. doi:10.2519/jospt.2004.0783

Key Words: foot, manual therapy, metatarsophalangeal joint, turf toe

Conservative treatment of Grade III acromioclavicular joint injuries usually consists of immobilization of the arm in a sling for 2-4 weeks followed by physical therapy. The initial phase of rehabilitation is greatly hindered by the fact that initial sling removal often exacerbates a patient's symptoms. This increase in pain leads to muscle guarding and spasms, which, in turn, limit the extent of range of motion and strengthening exercises that can be performed. The purpose of this article is to describe a taping technique aimed at reducing a patient's pain in order to facilitate more rapid gains in range of motion, strength, and function. Two case studies are presented to better describe the indications for the technique's use and demonstrate its intended results. The initial outcomes are promising for increasing patients' tolerance to physical therapy and, thus, decreasing their length of stay.

J Orthop Sports Phys Ther. 1997;25(6):390-394.

Key Words: acromioclavicular joint, taping, rehabilitation