Hallux valgus is a common orthopedic pathology.Usually treated surgically.Conservative methods - exercise therapy, massage, physiotherapy, medications - play a significant role in the prevention and postoperative rehabilitation of hallux valgus.All treatment methods for hallux valgus and big toe deviation will be discussed in the article.
What is hallux valgus
It is a disease in which the big toe moves to the side and a bone appears in the region of the metatarsophalangeal joint.The hallux valgus pathology code according to ICD 10 is M20.1.
Main reasonHallux valgus disease is consideredhereditary connective tissue weakness.The provoking factors are:
- wear tight shoes;
- constantly walking in high heels;
- excessive loads.
Less commonly, hallux valgus deformity occurs due to developmental defects, injuries, or other illnesses.
Degrees of Hallux Valgus and its symptoms
There are several classifications of hallux valgus, which distinguish 3 or 4 degrees of pathology.The authors of the guidelines for orthopedists use the following systematization of hallux valgus stages:
| Degree | Deformation angle, in degrees | Signs of deformation |
| 1 (weak) | Less than 20 | Painless nodule.Sometimes discomfort appears after a long walk. |
| 2 (average) | 25-35 | Accentuated curvature, difficulty walking in high-heeled shoes with narrow toes.Possible pain, calluses and recurrent inflammation of the joint. |
| 3 (heavy) | Over 35 | Severe deformity, problems choosing footwear, difficulty standing and walking, changes in gait.Frequent pain, corns, calluses and concomitant changes in the foot are typical. |
Treatment of hallux valgus deformity of the first toe
The only way to correct severe hallux valgus is surgical correction.Conservative techniques are mainly used in the initial stages of deformation.Hallux Valgus is treated by an orthopedist.
The main method for determining the degree of pathology is x-rays, which are taken in two projections with a load.Additionally, the doctor may prescribe plantography, computed tomography, magnetic resonance imaging and other studies.
Surgery to correct hallux valgus
Surgical treatment is indicated for moderate to severe hallux valgus deformity.At the patient's request, mild surgery is sometimes performed to eliminate a cosmetic defect.There are many methods for removing a lump:
- exostosis resection;
- osteotomy;
- tendon transfer according to McBride et al.
The intervention is carried out using the usual method or by percutaneous correction (with small punctures).It is possible to remove the growth with a laser.One or more incisions are made on the side or back of the foot.The cone is cut, sometimes artificial fractures of the main phalanx or 1st metatarsal are created, the fragments are fixed with screws.
In the initial phase of Hallux valgusthe operation lasts 30-40 minutes, with severe deformation –up to an hour and a half.
Rehabilitation after removal of Hallux valgus
Recovery after removing the lump lasts about 2 months.The key to a complete recovery is strict adherence to the orthopedist's recommendations.If rehabilitation rules are ignored, long-term complications may arise after surgery - reformation of hallux valgus or lifelong restriction of movement in the joints.
What shoes to wear after surgery
From the second day onwards you will be able to walk in Baruk's shoes.Before the swelling goes down, you mustmove as little as possible, most of the time the patient lies down with the leg elevated.After 2 weeks, walking restrictions will be lifted.The use of Baruk boot remains mandatory for 1-1.5 months after bone excision.So you can wear wide sneakers or boots with a wide toe.
You need to give up jumping for six months.
Is it possible to have a massage after surgery?
Massage can be done after the wound has completely healed.To improve blood circulation and lymphatic drainage, massage the entire lower part of the limb.The procedure begins with caresses.Then, knead the sole and back of the foot in circular motions.Hold the ankle joint with your hands and move towards the knee.In the final phase, the blows are performed again.
Exercise therapy for feet with screws
Physiotherapy is a mandatory part of the hallux valgus rehabilitation period and begins in the third week after surgery.First, the finger is bent and extended 3 times, held in each position for 10 seconds.Exercises are repeated 3-4 times a day.All movements are made carefully, avoiding discomfort.
From the second month after removal of hallux valgus, the number of repetitions increases to 7-8, the number of approaches - to 6-8 per day.Discomfort is acceptable.Active movements are complemented by passive ones (with the hands).After a month and a half, you need to stand on your toes 5-6 times a day, 7-8 times, and hold this position for about 10 seconds.
It is useful to walk on inclined surfaces and climb stairs.
Corrective bandages
Corrective dressings are used after stopping use of the Baruk shoe.The products consist of two bandages connected by a hinge and fix the thumb in the abduction position.After 1-1.5 months, the bandage is replaced with silicone inserts.The leg should not be compressed– this interferes with blood circulation and can cause soft tissue injuries.
How to Get Rid of Hallux Valgus Without Surgery
In the advanced stages of hallux valgus, it is impossible to completely cure the bunion through conservative correction.All conservative methods are used only to eliminate pain, prevent complications and progression of the curvature.
To guarantee resultstreatment should be started at the first signsappearance of hallux valgus.Special exercises, massage, physiotherapy, the use of orthopedic devices in combination with the use of folk remedies are effective.
Foot and big toe massage
It is recommended that the procedure be carried out after a hot shower.
- The leg with the deformed toe is bent at the knee and placed on the thigh of the other leg, with the sole facing inward.
- The sole is kneaded with the fist, alternately pressing different areas of the distal part.
- The hallux valgus node is massaged in circular movements and then all fingers are straightened and massaged.
- To stimulate blood and lymph flow, wrap your arms around your leg and move your palms from your foot to your knee.
Medications for deformity
To eliminate inflammation in the hallux valgus area, topical anti-inflammatories are used.
The formation of hallux valgus is accompanied by the development of arthrosis and deterioration of local metabolic processes.Therefore, to improve blood flow and stimulate tissue repair, medications with chondroprotective effects are used.
There are special complex ointments against Hallux valgus.For example, a special cream contains shark oil, natural oils and extracts that have an anti-inflammatory effect, eliminate pain and stimulate tissue regeneration.
To reduce pain and inflammation, you can use patches, compresses with propolis, burdock and turpentine, red clay and sea salt.All compositions are applied to the protruding bone, covered with a bandage, left for 1-2 hours and then washed off.
Can hallux valgus be corrected with exercise?
Exercises for hallux valgus can strengthen ligaments and muscles and have a positive effect on small bones.Therapeutic gymnastics is performed after warming up the hallux valgus deformity using massage.Perform the following exercises:
- Walk alternately on your heels with support on the outer and inner edges of the foot.
- Walking on a suspended carpet.
- Rolling an elastic ball.
- Extension and compression of the toes in the sitting position.
- Grasp objects (pencils, napkins, small toys).
- Drawing various shapes in the air.
- Stretch the elastic placed on your big toes, moving your feet apart.
- Flexion and passive extension of the diseased joint with the hands.
Exercises are performed daily, complemented with stretching and free caressing to relieve tension in the muscles.Only constant loads can affect the course of the disease.
Orthopedic devices
Taking the material into account, all Hallux valgus devices are divided into three groups: soft, semi-rigid, hard.Soft ones are used during the day, medium-hard ones - up to several hours.Rigid ones are designed to protect the foot at night.
Depending on the type of construction, there are:
- Insertions between fingers— correct the position of the first toe in the initial stages of the deformity or in the postoperative period.Made from soft silicone.
- Sole pads- soft products used to improve shock absorption.They are sometimes available with a septum that eliminates hallux valgus.
- Correctors and bandages— recommended for moderate and severe stages.They can be soft or semi-rigid and hold a significant part of the foot.They are also used for valgus feet.
- Orthopedic splints— adjust the hallux valgus angle.Used in later stages and only at night, as they are incompatible with shoes.
Physiotherapy for hallux valgus
Physiotherapy procedures are considered part of a comprehensive treatment and go well with massage and exercise therapy.The following methods are used:
- Paraffin therapy— provides deep warming of muscles and ligaments, improves blood circulation, activates local metabolism.
- Therapeutic mud- has the same effect as paraffin.Relieves muscle tension.
- laser therapy— helps expand capillaries, reduce swelling and improve protein absorption by cells.
- Ultrasound Therapy- activates metabolism and microcirculation in tissues.Stimulates collagen production.Reduces pain and swelling in the hallux valgus area.
- Shock wave therapy— eliminates stagnant processes, stimulates blood flow, improves the supply of oxygen and nutrients and activates regeneration.It effectively acts not only on ligaments and muscles, but also on osteochondral tissue.
Hallux valgus prevention
Prevention of hallux valgus must start early.Special attention should be paid to the health of children's feet, whose family has relatives who suffer from hallux valgus with swellings on the thumbs.A bunion forms when there is a transverse flat foot, which is why children and adults with this pathology need to regularly perform exercises to strengthen the ligament-muscle apparatus.
It is important to choose the right shoes - loose, with a stable sole, made from natural materials.You should give up jumping.It is helpful to use arch supports.If indicated, the use of orthopedic insoles is recommended.Regular, but not excessive, physical activity is beneficial.
You must get rid of excess weight to reduce static load.