UKC

I'm trying to find feedback from anybody out there who has continued getting long days out on the hill carrying a mountaineering pack, after having fusion of the big toe main joints (that's ankylosis of the 1st metatarso-phalangeal joints for the technically minded). I'm considering this option because of long-term osteoarthritis in those joints (past cow tread injuries) which is spoiling my mountaineering trips due to foot pain and swelling after the first day out. All comments welcome. Cheers.

In reply to rickukc: I have similar osteoarthritis of the big toes, but by sticking with more rigid boots (4 season and winter boots) I have been able to continue doing decent mountain days.. Still painful at times, but the one person I know who had the joint pinned was not very happy with the outcome.

In reply to Denzil:

Ditto - more rigid boots helped a lot, but found that moving domestic footwear to stiffer stuff also helped a lot - stiffer approach shoe for everyday, stiffer brogue-like stuff for posh etc., and sent all old bendy footwear to the charity shop.
Also found that there is great variation in where the boot bends, so borrowing various mate's boots for an afternoon paid dividends. … eg., can still nordic ski tour using ex-MOD boots as the "bend" is more limited and gradual.

In reply to npgm1: agree on the different boots and bend location. I always wore Scarpa SL before the problem but they bend at just the wrong place. I've found Nike Air Pegasus trainers to have a manageable bend location - though not for long distances. Merell Kahuna sandals are also pretty good - they have a rigid section on the sole pattern at just the right point for me and I can do a few miles in them. I had a second pair at work which I wore when I went in on the motorbike.

In reply to rickukc:

Disappointed that the thread wasn't announcement of a new, limitless, cheap energy source from feet.

In reply to rickukc:

Thanks Guys. I've been using stiffer shoes and boots with success for some years, ski touring with rigid boots and cycling are no problem, but long days out walking/mountaineering with a big pack are still a problem, with unusable painful swollen feet on the worst days. I'll stop whingeing now, and keep thinking......lighter gear, better painkillers, better navigation (Ha!), better orthotic soles, maybe fusion(?), maybe take up knitting (No!!!). Thanks for the replies anyway, I'd love to hear from anybody who is mountaineering with fused toe joints, there must be a few at least. Cheers.

In reply to rickukc:

I have had this done on one foot. This was 20 years ago and the toe was plastered while it healed. This has left the big toe slightly elevated but the only problem that this causes is that my socks, and internal lining of footwear, wear out above the nail of the toe. Otherwise the op was successful and I can wear, and use, rock boots comfortably on this foot. The other joint is painful at times and I need to use stiff footwear to reduce the pain. Wearing rock boots all day is a big no-no as the joint gets very painful. I believe that the procedure has now changed and the joint is left to fuse without plastering and I am considering getting it done.

In reply to phizz4:

Thanks that's useful info, I didn't mention rock climbing but I do love it, except where I have to screw those toes into some horrendous crack and twist to get a grip. Most other situations you can get away with using the side of the foot instead of toes.

In reply to rickukc:

I had similar op to you a couple of years ago to treat arthrosis and pain in the joint - in my case, pinned, fused and plastered (and big toe shortened by about a centimetre as a result of bone removal either side of the joint). I'd echo much of what's been said by the others, particularly re benefit of stiffer, very carefully fitted footwear. For hillwalking, I wear my Scarpa Mantas a lot more now; for rockclmbing, I'm happy in edging boots like the Scarpa TechnoXs I've just got but have had to retire my Anastasi Pinks and the like (wish I could get my hands on Scarpa's old series of Crag Rat/Super Rat/Rockstar or La Sportiva Megas - I reckon they'd be perfect compromise). The only real reminder I get that the joint's fused is from hard smearing on gritstone, where my foot simply won't fold as much as it did. Recently had a couple of days on the Cuillin Ridge traverse in 5.10 Camp 4 approach shoes and never had to give the fused joint a thought. All in all, I've been very happy with the result: all pain's been abolished, it's very strong and it's given me a new lease of life after years of doing less and less climbing. The two main thing I'd add to the advice the others gave are:
(1)choose your surgeon with care, i.e., have a good chat with your GP and ask for a referral to a recognised opinion leader in a teaching hospital if there's one close enough and then make sure the surgeon understands what you need your foot to do. Ask around local physios - they tend to have clear consensus on who the good guys are, including the ones that are good at getting a good result for sportspeople.
(2) beware of gait changes that can cause knock-on damage to knee, hip, etc. I got a referral to podiatric/biomech physio for help to rebalance my gait but still get a bit of hip ache occasionally.

Hope this helps.

Gary

In reply to Gary Coggon:

Thanks Gary, that's really helpful, the thought of having to do less and less rock climbing and mountaineering when I've only just retired and got more time to enjoy it, is an a truly appalling idea, even though one has to accept whatever comes! There must be quite a few mountaineers who carry on with reduced or missing toes as a result of frostbite amputations, so it would be damned annoying if I can't find a satisfactory solution. I know we were only designed to live 35 years or whatever, but nowadays you can't help feeling there has to be a good solution to what is a mainly mechanical hitch rather than a medical game-changer. PS A few years ago I started putting cut-to-shape sheets of mild steel off the side of an old washing machine, inside my rock boots under the insole, worked an absolute treat for a few weeks before the sheets started to crack and break up. Needless to say I don't wear them too tight either.

Thanks for the post

Rick

In reply to rickukc:

My pleasure, Rick. Wish I'd had it done years ago. Happy to chat if can be of help at some stage. 07802-183232

Best of luck

Gary