Hallux Valgus AKA ‘Bunions’
In today’s blog we are continuing with our foot related problems and focusing on the big toe and a condition known as Hallux Valgus or more commonly as Bunions.
Hallux Valgus is a deformity of the 1st metatarsophalangeal (MTP) joint, which is the joint between the foot and the big toe. It is characterised by a valgus (lateral) deviation of the big toe and a varus (medial) deviation of the first metatarsal, resulting in the development of small bony bumps around the joint, often accompanied by overlying bursitis.
Hallux Valgus develops slowly over time, progressively increasing in size, until a bony deformity is seen which limits movement at the 1st MTP joint and causes pain when pressure is applied (wearing footwear). The deformity can often make the big toe turn in, so far, that it moves on top of the 2nd toe.
Bunions are a result of complex biomechanical changes that occur in your feet and develop secondary to a combination of intrinsic and extrinsic causes. These factors include:
Type of footwear – constricting footwear, such as high heels and those with a tight toe box can compress the big toe contributing to bunion development. The slope of the shoe causes the front of the foot to bear most of the weight. This encourages the forefoot to widen, and in combination with a tight toe box, causes the toes to become angled and squeezed together. They are seen most commonly in women and become more common as people get older.
Excessive pronation or the presence of flat feet increases the pressure on the medial border of the hallux (big toe), resulting in stress on the medial capsular structures.
Other causes include degeneration of the medial capsule, neuromuscular disorders and other intrinsic diseases which lead to a breakdown in the integrity of the joint capsule.
Symptoms of Hallux Valgus include:
In the early phases it is often asymptomatic
As the deformity develops pain arises over the inside of the big toe
Pain is relieved by removing shoes or wearing flexible shoes
Redness and blistering may occur over the inflamed area
Pain may be felt when weight bearing through the big toe
Hallux valgus can generally be diagnosed in the clinic by your healthcare practitioner. In many cases x-rays will be taken to assess the severity of the deformity and the extent of the joint degeneration.
Conservative treatment has a high success rate and focuses on:
Rest, Ice, Compression, Elevation (R.I.C.E) protocol to manage inflammation and pain
Padding and footwear correction to reduce friction over the medial aspect of the great toe
Correcting foot posture with, initially taping, and a functional orthotic is essential
Restoring movement to the 1st MTP
Restoring strength to the foot and leg.
If conservative management fails, and in more severe cases, surgery may be required to reconstruct the 1st MTP joint and remove the bony exostoses.
4 good tips to help prevent the development of bunions include:
Always wear appropriate supportive footwear.
Maintain good mobility and strength in the foot through regular exercise.
Apply self-release to the muscles of the foot and lower leg using a spikey ball or golf ball.
If you notice a bunion beginning to appear, roll your great toe in a clockwise and anti-clockwise direction 50 times per day, to help break down smaller calcium deposits before they become painful exostoses.
Wear supportive taping (when playing sport) or orthotics if you have pronated feet.
So that’s an overview of hallux valgus and how it occurs. If you have any questions or comments, please email us at firstname.lastname@example.org and we will be happy to answer them for you.
If you suffer from 1st MTP pain, feel free to call us on (08) 9486 8653 and our therapists will be happy to chat with you.