Hallux valgus is a common orthopedic pathology.It is usually treated surgically.Conservative methods - exercise therapy, massage, physiotherapy, drugs - play a significant role in the prevention and postoperative rehabilitation of hallux valgus.The article will discuss all methods of treating hallux valgus and big toe deviation.
What is hallux valgus?
This is a disease in which the big toe moves to the side and bone appears in the area of the metatarsophalangeal joint.Pathological code for hallux valgus according to ICD 10 is M20.1.
The main reasonHallux valgus disease is consideredhereditary weakness of connective tissue.The provoking factors are:
- wearing tight shoes;
- constant walking in heels;
- excessive loads.
Less commonly, hallux valgus deformity occurs due to developmental defects, injuries or other diseases.
Degrees of Hallux Valgus and their 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 the phases of hallux valgus:
| Degree | Deformation angle, in degrees | Signs of deformation |
| 1 (weak) | Less than 20 | A painless lump.Sometimes discomfort occurs after a long walk. |
| 2 (average) | 25-35 | Strong curvature, difficulty walking in shoes with heels and narrow toes.Possible pain, corns and recurring inflammation of the joint. |
| 3 (heavy) | More than 35 | Severe deformity, problems choosing footwear, difficulty standing and walking, changes in gait.Frequent pains, calluses, corns and accompanying 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 used mainly in the initial stages of deformation.Hallux Valgus is treated by an orthopedist.
The main method for determining the degree of pathology is an X-ray, which is recorded in two projections with a load.Additionally, the doctor may prescribe plantography, CT, MRI and other studies.
Hallux valgus correction surgery
Surgical treatment is indicated for moderate to severe hallux valgus deformities.At the patient's request, mild surgery is sometimes performed to remove an aesthetic defect.There are many methods to remove the lump:
- resection of exostosis;
- osteotomy;
- tendon transfer according to McBride et al.
The intervention is performed using the usual method or percutaneous correction (using small punctures).The growth can be cut with a laser.One or more incisions are made on the side or back of the foot.The cone is cut off, sometimes artificial fractures of the main phalanx or 1st metatarsal bone are created, the fragments are fixed with screws.
In the initial stage of Hallux valgusthe operation takes 30-40 minutes, with severe deformation –up to an hour and a half.
Rehabilitation after removal of hallux valgus
Recovery after the removal of the lump takes about 2 months.The key to complete recovery is strict adherence to the orthopedist's recommendations.If the rules of rehabilitation are neglected, complications may develop in the long-term after the operation - re-formation of hallux valgus or limitation of movement in the joints throughout life.
What shoes to wear after surgery
From the second day you can walk in Baruk's shoes.Before the swelling goes down, you shouldmove as little as possible, most of the time the patient lies with his leg elevated.After 2 weeks, walking restrictions are lifted.The use of the Baruk boot remains mandatory for 1-1.5 months after bone excision.Then you can wear loose sneakers or boots with wide toes.
You have to give up heels for six months.
Is massage possible after surgery?
Massage can be done after the wound is completely healed.To improve blood circulation and lymphatic drainage, massage the entire lower limb.The procedure begins with stroking.Then, in circular motions, knead the sole and the back of the foot.Grasp the ankle with your hands and move towards the knee.In the final phase, shots are taken again.
Exercise therapy for feet with screws
Physical therapy is a mandatory part of the rehabilitation period for Hallux valgus and begins in the third week after surgery.First, the finger is bent and extended 3 times, holding each position for 10 seconds.The exercises are repeated 3-4 times a day.All movements are done carefully, avoiding discomfort.
From the second month after the 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 (using 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 an inclined surface and climb stairs.
Corrective bandages
Corrective bandages are used after stopping the use of the Baruk shoe.The products consist of two bandages connected by a hinge and fix the thumb in 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 with conservative correction.All conservative methods are used only to eliminate pain, prevent complications and progression of curvature.
To ensure resultstreatment should be started at the first signsoccurrence of hallux valgus.Special exercises, massage, physiotherapy, wearing orthopedic aids in combination with the use of folk remedies are effective.
Foot and toe massage
The procedure is recommended after a warm bath.
- The leg with the deformed toe is bent at the knee and placed on the thigh of the other leg, with the sole facing inwards.
- The sole is kneaded with the fist, alternately pressing different areas in the distal part.
- The hallux valgus lump is massaged with circular movements, then all fingers are stretched and kneaded.
- To stimulate the outflow of blood and lymph, wrap your hands around your leg and move your palms from the feet to the knees.
Medicines for deformities
Local anti-inflammatory drugs are used to remove inflammation in the hallux valgus area.
The formation of hallux valgus accompanies the development of arthrosis and deterioration of local metabolic processes.Therefore, chondroprotective drugs are used to improve blood flow and stimulate tissue regeneration.
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, relieve pain and stimulate tissue regeneration.
To reduce pain and inflammation, you can use plasters, compresses with propolis, thistle 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 exercises?
Hallux valgus exercises can strengthen ligaments and muscles and have a positive effect on small bones.Therapeutic gymnastics is performed after warming up the hallux valgus deformity with massage.Do the following exercises:
- Alternating walking on the heels with support on the outer and inner edges of the feet.
- Walking on the floor.
- Rolling an elastic ball.
- Extension and compression of the toes in a sitting position.
- Grasping objects (pencils, napkins, small toys).
- Drawing various shapes in the air.
- Stretching the elastic band placed on the big toes by spreading the foot.
- Passive flexion and extension of the affected joint using the hands.
Exercises are performed daily, complemented by free stretching and massage to relieve muscle tension.Only constant loads can affect the course of the disease.
Orthopedic devices
Considering the material, all devices for Hallux valgus are divided into three groups: soft, semi-rigid, hard.Soft ones are used during the day, semi-hard ones - up to several hours.Rigid ones are designed to secure the foot at night.
Depending on the type of construction, they differ:
- Interfinger inserts— to correct the position of the first finger in the early stages of the deformity or in the postoperative period.Made of soft silicone.
- Pads for soles- soft products used to improve shock absorption.Sometimes they are available with a septum that eliminates hallux valgus.
- Concealers and bandages— recommended for medium and heavy 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.They are used in later stages and only at night, because they are incompatible with shoes.
Physiotherapy for Hallux valgus
Physiotherapy procedures are considered part of comprehensive treatment and go well with massage and exercise therapy.The following methods are used:
- Paraffin therapy— ensures deep warming of muscles and ligaments, improves blood circulation, activates local metabolism.
- Therapeutic mud- have the same effect as paraffin.Relieves muscle tension.
- Laser therapy— helps expand capillaries, reduce swelling and improve protein absorption in cells.
- Ultrasound therapy- activates metabolism and microcirculation in tissues.Stimulates collagen production.Reduces pain and swelling in the area of hallux valgus.
- Shock wave therapy— eliminates stagnant processes, stimulates blood flow, improves the delivery of oxygen and nutrients, and activates regeneration.It has an effective effect not only on ligaments and muscles, but also on osteochondral tissue.
Prevention of hallux valgus
Hallux valgus prevention should be started early.Special attention should be paid to the health of children's feet, whose family has relatives who suffer from hallux valgus with bumps on their thumbs.A bunion is formed when there is a transverse flat foot, so children and adults with this pathology must regularly perform exercises to strengthen the ligamentous-muscular apparatus.
It is important to choose the right shoes - loose, with a stable sole, made of natural materials.You should ditch the heels.It is useful to wear arch supports.If indicated, the use of orthopedic insoles is recommended.Regular but not excessive physical activity is beneficial.
You should get rid of excess weight to reduce static load.