20 patients (40 feet) with hallux limitus were included in this randomized controlled trial to determine the effects of adding support under the first metatarsophalangeal joint of custom-made foot orthoses on the range of joint mobility. The outcomes evaluated were the relaxed position of the hallux and the maximal extension of the hallux. Patients were assigned to receive a custom-made foot orthosis with or without added support under the first metatarsophalangeal joint for a period of 6 months. While both groups demonstrated significant improvements in both the relaxed position of the hallux and the maximal extension of the hallux, the addition of support under the first metatarsophalangeal joint provided significantly greater improvements in both outcomes.