During which phase of the stance is a patient with hallux rigidus likely to experience the most discomfort?

Patients with hallux rigidus experience stiffness and pain in the first metatarsophalangeal (MTP) joint, which is crucial for normal propulsion during gait. During the late stance phase, the body’s weight shifts onto the forefoot as the heel lifts off the ground, and this stage involves the critical action of the hallux aiding in the push-off movement. Since this is when the toe is fully extended, any limitation or pain in the MTP joint can significantly exacerbate discomfort.

In contrast, during initial contact and midstance, the weight is primarily borne by the heel and midfoot, which alleviates stress on the hallux. While there may still be some discomfort experienced at these stages, it tends to be less severe compared to late stance. Terminal stance follows late stance but is more about preparing for the swing phase, thus reducing the reliance on the hallux.

Therefore, it is during the late stance phase where the characteristics of hallux rigidus—pain and limited mobility of the big toe—are most severely challenged, leading to increased discomfort for the patient.