Functional Hallux Limitus or Rigidus Caused by a Tenodesis Effect at the Retrotalar Pulley: Description of the Functional Stretch Test and the Simple Hoover Cord Maneuver That Releases This Tenodesis

Vallotton, J., the, S. E. J. O., 2010. (n.d.).

Journal of the American Podiatric Medical Association | Allen Press. Meridian.Allenpress.com

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Functional hallux limitus is a loss of metatarsophalangeal joint extension during the second half of the single-support phase, when the weightbearing foot is in maximal dorsiflexion. Functionally, it constitutes a sagittal plane blockade during gait. As a result, the mechanical support and stability mechanisms of the foot are disrupted, with important consequences during gait. Functional hallux limitus is a frequent, though relatively unknown condition that clinicians may overlook when examining patients with complaints that are not limited to their feet, for they can also present other symptoms such as hip, knee and lower-back pain. The purpose of this article is to present a critical review of the literature on functional hallux limitus and to explain a previously described and simple diagnostic test (flexor hallucis longus stretch test) and a physiotherapeutic manipulation (the Hoover cord maneuver) that recovers the dorsiflexion of the hallux releasing the tenodesis effect at the retrotalar pulley, which according to our clinical experience is the main cause of functional hallux limitus. The latter, to the best of our knowledge, has never been described before.

機能性母趾限界は、体重を支える足が最大背屈状態にあるときの、単一支持期の後半における中足指節関節伸展の喪失です。機能的には、歩行中の矢状面遮断を構成します。その結果、足の機械的サポートと安定性メカニズムが破壊され、歩行中に重要な結果が生じます。機能性幻覚限界は頻繁ですが、臨床医が足に限定されない愁訴のある患者を検査するときに見落とす可能性がある比較的未知の状態です。股関節、膝、腰痛などの他の症状も示す可能性があるためです。この記事の目的は、機能的な趾限界に関する文献の批評的なレビューを提示し、前述の簡単な診断テスト（長母趾屈筋ストレッチテスト）と足の指の背屈を回復する理学療法操作（フーバーコード操作）を説明することです。私たちの臨床経験によれば、長母趾屈筋は、距骨後滑車で腱固定効果を解放します。これは、機能的な趾屈筋の主な原因です。後者は、私たちの知る限り、これまでに説明されたことはありません。