Hallux valgus
Hallux valgus is a very common issue in society. Many people suffer from pain in the big toe after prolonged pressure, wearing tight shoes, or moving the toe. But what exactly is behind this foot deformity, and what can be done about it? This blog addresses these and other questions about hallux valgus, its causes, symptoms, and treatment options.
Cause Hallux valgus
Hallux valgus is Latin for "big toe turned outwards". The causes of hallux valgus are varied and diverse. The deformity usually runs in families. Weak connective tissue combined with a splayed foot is usually another cause. This misalignment causes irregular loading of the arch of the foot and the arch of the foot sinks. Statistically, men are much less likely to suffer from hallux valgus than women. In addition to weak connective tissue, tight shoes with heels can also be another cause of hallux valgus.
Pain in the hallux
Typical symptoms of hallux valgus are:
- Callus formation on the inside of the ball of the foot
- Sensitivity to pressure when wearing shoes
- Pain due to inflammation of the joint bursa
The visually visible and usually red bunion is not a real bone spur, but rather the head of the first metatarsal bone. Due to the rotation, it now appears as a painful bunion. A nerve that is located in this place near the big toe can be irritated in the shoe, which is then responsible for the frequently occurring burning, stabbing pain or numbness. This discomfort often occurs at night or during rest periods.
The friction or irritation in the shoe can in turn cause bursitis. The other toes can often be pressed in by the abnormal shape, so that they too are forced into a different position. Hammer toes or claw toes often develop. If the problem gets worse, surgery can be the last resort.
How do you avoid hallux valgus?
If you are predisposed to hallux valgus, it is difficult to prevent the deformity from progressing. The leverage forces that arise during the rolling process mean that the bandages and splints cannot be used effectively. The various night splints only provide limited relief. It is therefore important to wear comfortable shoes to prevent local irritation in the area of the "bone spur". It is recommended that you train your foot muscles well.
How is hallux valgus diagnosed?
The diagnosis is made based on the typical appearance and symptoms. An X-ray can be used to measure the extent of the misalignment and identify any joint changes.
Treating hallux valgus conservatively
Treatment depends on the extent of the misalignment and the symptoms. Minor misalignments can be corrected with targeted gymnastics, physiotherapy and special footwear, custom insoles or night splints.
Physiotherapy for hallux valgus
In physiotherapy, weak foot and lower leg muscles can be specifically strengthened in order to strengthen the foot as a whole. Hypertonic muscles, i.e. tense muscles, around the foot and lower leg can be relaxed using massage, stretching exercises, taping and fascia training so that there is a good balance between tension and relaxation in the foot or in the leg axis. Over time, this will have a positive effect on the foot's resilience.
The gait pattern can often change due to long-term problems with the big toe joint. In physiotherapy, the patient is trained in their perception and various exercises are instructed to improve the gait pattern so that the foot is optimally loaded during the gait cycle.
In addition, the patient is instructed at home to maintain the mobility of the big toe joint using specific mobilization and massage exercises for the big toe.
Gait analysis and insoles for hallux valgus
The aim of conservative treatment is to stop the progression of the deformity and, in the best case, to achieve an improvement.
With our podiatric examination, we want to find out what the cause of the hallux valgus is. We can then treat it with various aids. In the case of a splay foot, a very common cause, we recommend custom-made insoles. They support the arch of the foot and help to better distribute the load on the forefoot, which in turn relieves the hallux. We can also support you with shoe advice or exercise recommendations.
Toe orthoses for hallux valgus
Another aid is custom-made toe orthoses. With the help of a two-component bond, we can offer so-called custom-made toe orthoses made of silicone. They can correct the toes and relieve pressure points or corns that have developed. In addition, several toes can be treated at the same time. If there is also a hammer toe, a combined solution can be found and several toes can be included, as it is made completely for your feet. Come and see us if you suffer from misalignment of the toes and we can assess how we can help with custom-made silicone toe orthoses.
Taping for hallux valgus
If you notice that the tension in the tendon is causing pain, then it is important that the toe is stretched so that the tendon of the extensor hallucis longus muscle cannot shorten any further. Of course, this can be done regularly during the day by hand, or you can use a Hallufix taping loop. It is a tape-like band that is placed around the toe. It exerts a pull on the toe, creating a constant stretch. As it clings to the foot easily and without being bulky, it can be worn in shoes or barefoot without any problems. It is recommended not to wear the tape at night, as the pull can be extremely uncomfortable and you can wake up in the night. This can be better controlled during the day. Of course, conventional taping methods can also be used in physiotherapy to generate a stretch in the toe.
Appropriate footwear for hallux valgus
Shoes can have a major influence on the speed at which hallux valgus progresses. A shoe with a too flexible, soft sole allows walking patterns that promote hallux valgus. In addition, the load on the metatarsophalangeal joint of the big toe can be little to not at all controlled, which can lead to over-stimulation of the joint. Osteoarthritis threatens to develop, which in turn can cause pain when rolling.
Shoes that enable guided and therefore gentle rolling are those of the Anova brand. A so-called Anova guide is built into the outsole, a plastic element that guides the foot into the correct rolling line. This can enable a shock-absorbing step and a gentle rolling process. This is not only good for hallux valgus, but also for joints that are involved in the rolling process, such as the back.
We are happy to be there for you in Dübendorf or Winterthur for advice and to try on shoes!
You can find more information about the structure and model selection of Anova shoes on the Anova website.
Hallux valgus surgery
Have you tried all conservative treatments? However, if symptoms occur regularly and the level of suffering increases, then surgery is a good and justified solution. Hallux valgus is not a dangerous disease. As long as it does not cause any symptoms, surgery is not recommended. Preventive surgery is also not advisable because it will always be possible to correct it later. Even if the misalignment has increased significantly, the chances of success remain good.
If you want to know more about the surgical technique, then take a look at the In-Motion website:
"I have a hallux"
People often say "I have a hallux". What many people don't know, however, is that hallux is just the Latin word for big toe and does not mean the misalignment of the big toe described above. For us as specialists, this is always a reason to smile because it means nothing more than "I have a big toe".
FAQ Hallux valgus
Why do you get hallux valgus?
Hallux valgus is often inherited. However, it can also be caused or made worse by various misalignments. Sports that place a lot of emphasis on the forefoot, such as ballet, can also trigger the problem.
Are tight/high shoes to blame for hallux valgus?
Tight or high shoes do not necessarily cause hallux valgus, but they can cause a pain-free hallux valgus to become painful. Ultimately, tight and high shoes are not ideal for keeping the foot pain-free.
Does a hallux valgus surgery make sense?
In situations where the hallux valgus remains symptom-free and the misalignment does not progress, surgery is not recommended. If the misalignment increases and becomes more pronounced, it can lead to excessive strain on the metatarsophalangeal joints and thus to the development of hammer/claw toes. In these cases, surgery should be considered.
Hallux valgus and osteoarthritis
It is not uncommon for hallux valgus to cause arthrosis. However, there are often no or only minor symptoms. Surgery cannot guarantee that the progression of arthrosis will be stopped. However, preventive surgery is not recommended.
How can insoles help with hallux valgus?
Custom-made insoles can have an impact on the load on the big toe joint. The aim of conservative therapy is to stop the progression and relieve pain.
This is what Maritza Arias says
Dentist, playgroup leader and class assistant
Three years ago my foot started to hurt in the hallux. The doctor wanted to operate on me but I had doubts. A colleague recommended Lisa Petersen, podiatrist from Laufgsund. She examined me and gave me advice. Since then I have been wearing orthopedic custom insoles and shoes from Anova Medical, FinnComfort and MBT. I am very happy with them. I can walk without any problems. I don't know yet whether I should have an operation in the future but so far I am doing well.
I recommend Laufgsund, they are professional, helpful, competent and very personable.