Gary Moller: [DipPhEd PGDipRehab PGDipSportMed(Otago)FCE Certified, Kordel's and Nutra-Life Certified Natural Health Consultant]. ICL Laboratories registered Hair Tissue Mineral Analysis and Medical Nutrition Consultant.

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Tuesday, September 18, 2007

Podiatrist tells Gary off - Hallux Rigidus has been misdiagnosed

Dear Gary Moller, My name is Daniel Bagnall and I am currently practicing Podiatric Medicine in Australia.

I would just like to alert you re: your treatment for Hallux Rigidus (fix it by manipulation), that this patient of yours has been misdiagnosed. I’m sorry to be so blunt but as a practitioner I find it very frustrating when the incorrect terminology is being used on the internet, please take the time to refer to the medical literature before posting such material:-

Normal dorsiflexion ROM at the 1st MPJ is 65-70 degrees ROM, this can clearly be observed at precisely 4:00 min in your video, pause and observe the position of the hallux, is the hallux flexing <65-70 style="font-size:130%;">
Gary Moller responds:

Thank you Daniel for pointing out that there appears to be no reference to the use of manipulation of hallux rigidus in the literature. This is one of the reasons why I produced the video. You will note that I advised in the video that this procedure be done by a professional (I assume from your writing in protest that you are not trained in this procedure).

I was first taught this technique about 25 years ago when undertaking a course in deep tissue massage by a sports massage therapist who made his living working almost exclusively on Olympic class middle and long distance runners mostly in the United States. At the time he was considered by many athletes to be the best. The simplicity and the effectiveness of this method in dealing with "impacted" toe joints, as we called them back then was astonishing. These kinds of toe injuries are common in runners and can be crippling to the point of being career-ending. I have never seen a failure of this procedure. Of course we are usually dealing with these injuries early (About Grade I-II).

You will also note in my accompanying advice with the video the use of nutritional supplements such as glucosamine and MSM to assist healing. I doubt you will find anything about this in the literature on hallux rigidus either; but that does not stop be advising the use of these supplements because they help expedite recovery.

As the literature (erroneously) states, this condition is progressive. The treatment offered in the literature does nothing to prevent progression which I find appalling. I can tell you that the condition is reversible in addition to being progressive, if gotten to early. This mirrors the view given to many other conditions. Take blood pressure for example: the usual medical approach only deals with the symptoms and the condition inevitably progresses. In most cases the condition can be reversed. As with the sore big toe, the sooner one intervenes with effective treatment, the more complete the recovery.

In the case of the woman in the video, you need to remember that her toe had already been manipulated several times. The toe in the video demonstrates remarkable restoration of mobility (She is naturally hyper-mobile in her fingers and toes btw).

If I was to obediently follow the guidelines in the literature, this healthy and athletic woman would be subjected to needless and costly medical treatment and eventual disfigurement by deliberate joint destruction surgery - the inevitable outcome of this kind of "progressive injury". We commenced about three months after the injury (So it was hardly acute!) and recovery has been quick and uneventful (other than the pain of the manipulation).

This procedure works very well on little toes as well.
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