Hallux (Big Toe) Limitus & Rigidus Series
Part 5A – 1st Ray Cutout and 1st Met Cutout
We mentioned both 1st Met Cutout and 1st Ray Cut Out, let’s compare! Keep in mind the picture for this post gives a great visual showing each modification under their correct name.
1st Met Cutout: a design feature where a portion of the orthotic material around the first metatarsal head is removed (cut out). This helps relieve pressure from this area by facilitating more natural motion and providing pain relief by offloading this area.
Indications:
– Commonly used for patients with Hallux Rigidus or Hallux Limitus, where limited motion or pain occurs at the first MTP joint, this modification helps relieve pressure during toe-off in the gait cycle.
– Also used in cases where there is overuse of the first metatarsal like metatarsalgia or bunions
1st Ray Cutout: a design where the material underneath the first ray (the first metatarsal and the surrounding bones, including the first toe). It’s more comprehensive than a 1st met cutout since it takes into account the entire first ray structure, not just the metatarsal head. This relieves pressure under the entire first ray, which redistributes weight away from the first ray and promotes more efficient toe-off, especially in cases of overloading or restricted motion at the first MTP joint.
Indications:
-Used for conditions where the first ray (which includes the first metatarsal, first MTP joint, and the surrounding soft tissues) is affected by dysfunction, examples of this are hypermobility of the first ray, Hallux Limitus, Hallux Rigidus, or flat feet.
– Patients with bunions or first ray insufficiency (where the first metatarsal fails to plantarflex properly) may benefit from a 1st ray cutout.
Notes about the First ray:
– the first ray is unique in its mobility and stability, it can dorsiflex and plantarflex in relation to the midfoot, making it essential for the medial arch functioning by helping with stability and load transfer.
– the first ray plays a key role in shock absorption, especially during the heel
strike and push-off phases of walking and running
Key Joints Involved in the First Ray:
1. First Metatarsocuneiform Joint (connects the first metatarsal with the first cuneiform bone while helping first ray mobility)
2. First Metatarsophalangeal (MTP) Joint (where the first metatarsal meets the proximal phalanx of the big toe, which helps for propulsion during gait
🔗Connect on LinkedIn: www.linkedin.com/company/canada-orthomedix-inc
📲Follow for more content! Like and Comment!
⏰Stay tuned for more on this series!
