UKC

Asked about this on the other channel but no takers.... Still hurts so worth an ask on here too:

Having some issues this year with pain on the underside of my big toes.  The tenderness is centred on the 'foot side' area immediately next to the knuckle (on the long axis of the foot) and over towards the second toe side (on the short axis).  Sort of equivalent to an A2 pulley area on the fingers.  Some googling and asking chat gpt suggests Sesamoiditis but the pain and tenderness is on the bit of the toe I described, not the ball of the foot so unconvinced about that.  My big toes also click a fair bit if I flex them back and forth though unsure to what extent that may be related.  If I'm on a pitch for a while standing around on fairly small feet they can be pretty painful afterwards (even walking in trainers) and I think there can be some swelling.  First noticed and got quite bad on a trip in Feb earlier this year and don't feel like it's fully gone away.  Fortunately standing more on outside edges and/or heels at rests really helps and if they've got quite bad, they seem to improve surprisingly quickly (overnight really) to a more tolerable pain level.
Anyone else had this? Know what it is? How to get rid?

Could be something called "Turf Toe". I've got a similar problem (pain underside of big toe if I stand on small footholds) and started doing rehab exercises for it from this site: https://theprehabguys.com/turf-toe-rehab-exercises/

Assuming you’ve rules out Gout?

Thanks, my complaint certainly has similarities to turf toe by the sounds of it... I suspect rehab protocols would be the same so will try some stuff you linked

Yeah fairly certain it's not gout - seems far too correlated with climbing on small footholds on consecutive days for it to be caused by anything else.

I had toe pain, in the knuckle, I had an x ray and the Dr said could be early arthritis / narrowing of the joint space, but then he didn't have anything to compare it too. 

get the stiffest shoes you can and size them on the tighter side.

then as rehab increase the flexibility and strength of your big toes  

I think climbing shoes are inherently bad for toe joints. Thanks to tweaky elbows meaning I can't climb as hard, stopping wearing tighter shoes after experiencing joint pain in my big toes was an easy enough choice, and I've stopped getting the joint pain.

I had pain in the great toe joint when climbing but mainly when walking. 
Podiatrist made a stiff shoe insert but this didn’t work. 
Consultant gave it a cortisone injection which worked for a short while. 
An X-ray showed that one bone had ground into the other forming a slight ball and cup. An operation was recommended to shave the cup side back to being round. This was done under a local and the consultant added a small piece of wire to slightly tilt my toe upward to aid walking. 
This was 10 years ago and it has been fine since. 
With the state of the NHS you may be put on the back burner re seeing a consultant so consider private, life is too short. 

Had similar issue. Never got an accurate diagnosis but it was caused by wearing too narrow shoes. Even though I’ve had the same or similar shoes my whole life, it resolved itself by changing shoes and the weather warming sufficiently to live out of my Teva sandals.