Climbers are used to having sore little piggies, whether it’s from jamming them into cracks or cramming them into tight, high-performance shoes. But toe pain is more serious when it doesn’t disappear after a few hours, and it happens to a lot of climbers because of the way we use and abuse our feet. Chronic stiffness and swelling in the big toe joint is an early sign of osteoarthritis that could permanently cramp your climbing style.
Osteoarthritis usually develops between ages 30 and 60, but it can strike even earlier. Genetics, personal anatomy, and injury history are the primary determining factors, but climbers can be especially susceptible. Dr. Yvonne Weber, a podiatrist and climber, says, “Hitting your toe against the rock [as in a lead fall] or rockfall hitting the toe can lead to osteoarthritis. Also, wearing super-tight or really flexible shoes and repeating the same move puts high torque on the joint.”Osteoarthritis occurs when the cartilage protecting bones wears away, leaving the bone ends to grind painfully against each other.
In the big toe, the condition is known as hallux rigidus, or the less serious hallux limitus, and it develops at the joint where the toe connects to the foot (A). Hallux rigidus may advance to the point where it’s extremely painful to walk—let alone climb—and it can require surgery to shave the bones, install a supportive implant, or fuse the joint.
Hallux rigidus frequently leads to bone spurring, a bony growth that’s painful and may require surgical treatment. Plus, by compensating for a sore toe while climbing or walking, you may overload other parts of the foot, possibly leading to neuroma (a tumor of nerve tissue) or hammer toe (deformation where toes are permanently bent). Pain, swelling, and decreased mobility in the joint are potential indicators of hallux rigidus. If you have a family history of osteoarthritis or have injured your big toe previously, Weber says, “Get an exam and X-ray, and you and the doctor can decide how seriously to take it.”
PREVENTION Hallux rigidus is a progressive condition, making early detection and preventive steps essential. If you experience pain or inflammation, Weber recommends the following:
- Wear stiffer climbing shoes to support the joint. A snug fit is good, too, to maintain stiffness. But avoid shoes that crunch the toes.
- While belaying or chilling between routes, put on stiff-soled shoes like your approach shoes or supportive sandals (read: not flip-flops). Don’t wear minimalist approach shoes or walk off a route in your climbing shoes.
- Get highly supportive and well-fitted sole inserts for your everyday shoes—anything to stabilize the joint day to day.
- Try MSM (methylsulfonylmethane) and fish oil to reduce inflammation, and glucosamine to strengthen cartilage.
- When pain flares up, avoid slabs and consider toproping versus leading or bouldering—you’ll move quicker and put less stress on the joint.
- Don’t mask chronic pain with anti-inflammatories—this condition won’t heal on its own. See a doctor.
IF YOU THINK TOE PAIN IS TO BE IGNORED OR THE CONSEQUENCES ARE MINOR, WATCH THE VIDEO BELOW. WARNING, THIS IS A GRAPHIC SURGERY VIDEO OF A TOE JOINT RUINED BY CLIMBING. THIS JOINT HAD TO BE REPLACED WITH A PROSTHETIC.