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Big toe strain. (Read 1613 times)

Fiend

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Big toe strain.
October 05, 2023, 11:56:40 am
Booked to go away climbing on the 14th. Strained my big toe at the wall on the 1st. Was pushing off it on a slab, fell off, and it was a bit sore underneath after.

Climbed a bit indoors on Monday, with some supportive taping. Could outside edge fine and inside edge on the ball of the foot okay, but not stand / smear directly on the big toe. Tried downturned shoes briefly at the end and they felt better. Toe felt better on Tuesday. A bit sore walking on Wednesday. Tried climbing inside on Wed night (albeit without taping) and it was just as bad as Monday. Felt absolutely fucking awful clonking around like a beginner and left the wall after 4 problems. This has got me pretty worried.

It's sore where the big toe meets the ball of the foot, and most sore when the toe is pulled back passively (including rolling the foot forward whilst walking on it). Actively clawing the toe forward feels fine, and applying force through the toe when it's actively clawed forwards feels okay. This leads me to believe that it's a strain of some ligament that supports the joint, rather than the big toe tendon itself.

Obviously I need this healed in a week's time (before anyone says it, yes I know this is optimistic, and don't worry I'm fucking upset enough already without that being pointed out) and obviously I need to maintain some sort of ability during that week (I become de-conditioned very quickly). My current plan is to stop anything that aggravates it including rolling my foot whilst walking, climbing on it front on, smearing, etc; taping it to restrict backwards stretching; wearing downturned shoes whilst climbing; avoiding any slab / vert climbing on small holds; training on steeper ground with bigger holds (plus the usual rehab, stretching, etc etc); some heat and massage to stimulate blood flow as I assume the acute RICE period has passed, plus the blood flow to my feet is terrible. If there's anything I've missed let me know.


sidewinder

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#1 Re: Big toe strain.
October 05, 2023, 12:16:32 pm
You spend most of your time not in climbing shoes. I have strained these before and it helped to ensure I was wearing supportive/stiff shoes day to day and indeed for approach (I took to wearing walking boots rather than relatively soft approach shoes).
I also found tighter shoes 'better' this may be what you have discovered with your downturned shoes being better. If sufficiently tight/stiff they effectively splint your toes together. Can also consider buddy taping big toe to first toe, but this quite relative toe length dependent.

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#2 Re: Big toe strain.
October 05, 2023, 12:32:14 pm
I did the same thing to my middle toe while surfing. It hindered walking, but not climbing, so naturally I did nothing about it. After 3 months I saw little improvement and decided to try and fix it. Basically I tried the same sort of things you'd do for a pulley injury, i.e. load it frequently - by pressing my toe into the ground and flexing it under gradually more extension, keeping pain to around a 3/10 or less. This worked pretty quickly, but it did come back several times over the next year if I accidentally hyper extended it again.

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#3 Re: Big toe strain.
October 05, 2023, 01:16:54 pm
Can also consider buddy taping big toe to first toe, but this quite relative toe length dependent.

Great if you have big second toe / royal noble ancestry, but wouldn't be any good with my caveman feet. Wonder if constructing a stiffener to put into shoes would help? A mate of mine did this type of injury out running, and I gave him an ancient pair of very stiff shoes to use at the wall and it helped loads.

Go see a podiatrist and make sure it's just a strain?

I would personally just stick to fingerboard campus / one foot climbing to give it a complete rest before trip. No point poking thr bear.  Just hope you aren't going to Pedriza or anywhere else slab central.

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#4 Re: Big toe strain.
October 05, 2023, 08:02:33 pm
Is the pain mainly on the sole side of the toe joint (as opposed to the dorsum (top) or the sides of the joint)? If so, it's probably a volar plate injury - very common from bending the toe backwards. A week is unrealistic for "healing" but it might be very manageable by then. Try stiff boots, or a stiffener in your current boots (people talk about plastic plates which could be fitted in). Anything to prevent the toe being bent back in this way.

It could be other things but unless the toe is literally pointing in the wrong direction even a bony injury wouldn't require anything more than buddy strapping and protecting it.

Fiend

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#5 Re: Big toe strain.
October 06, 2023, 10:13:45 am
Thank you for the replies, there's some very useful ideas there.

Supportive / stiff non-climbing shoes, good idea, some of mine are pretty soft. I can get stiffer shoes or rigid insoles (or construct a stiffener).

Pete: Yes it's on the bottom, it could be what you suggested, I think it's some sort of strain at the joint.

Chris: Given the general functionality I am sure it is just a strain, it's quite specific what makes it tender, and there's little / no pain away from that. Edit: I'm going to Pfalz, not Pedriza thank fuck. I was looking through guidebook photos yesterday and I think that Pfalz is pretty generous with features and friction that should allow working around the toe more than many other venues.

Climbing-wise I went to the Boardroom last night, with a clear plan:
1. Tape up well to see how supportive that was.
2. Break in my downturned shoes and see how supportive they are.
3. Work down from positions that feel completely fine (outside edging, ball of foot) to see when it starts to feel risky, to know what restrictions I have.
4. Try to find a way to make the god-awful beginner style "whole side of foot on hold" clomping feel less incompetent and inelegant.
5. Be extra careful to avoid any discomfort let alone re-aggravation.

The results were:
1. I improved the taping with more support / restriction to stop the toe flexing backwards, and this lasted through the session and kept it supported.
2. After softening my shoes earlier I could wear them fine, and again they supported the toe and stopped it flexing back.
3. This was fine, I found I could stand on some smaller holds as long as I was careful and kept the toe pointing more down than flexing back. I didn't try any positions that could flex it back.
4. No comment.
5. Yes I did this. Every single right foothold that wasn't a proper bucket, I looked down, assessed how to use it, and if it wasn't strictly outside edging / ball of foot / heel-hook, then I tested it gently before weighting it. Quite weird climbing like this but I didn't get any discomfort through the session. I do have a bit of surface tenderness this morning (different to the strain tenderness) which might be a combination of the taping and old scar tissue from when I gashed the underside on a hidden sharp stake stub whilst walking around the soft comfy grass above Craig Dorys in 2007.



Obviously I am not going to push it any further now. My plan is to stick to what I intended in my first post but with the addition of stiffeners / insoles.
« Last Edit: October 06, 2023, 10:26:22 am by Fiend »

mrjonathanr

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#6 Re: Big toe strain.
October 06, 2023, 10:19:27 am
You’re not really getting the rub of the green Matt, are you?

From what you posted about how you injured it, stif shoes to support the toe so it doesn’t bend upwards when on smaller holds sounds like it might be helpful? Hope it settles soon.

SA Chris

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#7 Re: Big toe strain.
October 06, 2023, 10:35:41 am
I'm going to Pfalz, not Pedriza thank fuck.

At least with crack climbing it's usually the small toes the seem to take the force.

Have a great trip.

 

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