First MPJ range of motion

First MPJ range of motion:
Generally considered as needing around 65 degrees at the first metatarsophalangeal joint (the third rocker) for normal gait (the foot has to rotate this far around a hallux fixed on the ground), but Nawoczenski et al (1999) found a poor correlation between the passive range of motion of the joint and the amount used during gait (a mean of 42 degrees was used during gait). May require more than 65 degrees for sporting activities. Up to 20 degrees of motion is available at the MPJ pure, the rest does not occur until the first ray plantarflexes.

Technique:
• range can be measured or just observed as being adequate/inadequate
• bisections
• hold STJ approximately neutral and the MTJ maximally pronated (ranges may be different if these joints are not held in a consistent position)
• observe or measure with a tractograph

Several different methods of measuring first MPJ range of motion have been shown to be reliable .

Clinical use:
• if range is restricted  structural hallux limitus
• if no range of motion  hallux rigidus
• compensation motions can occur elsewhere as a result of these restrictions

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