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 methods of treatment for hallux valgus and deviation of the big toe will be discussed in the article.
What is Hallux valgus
This is a disease in which the big toe moves to the side and a bone appears in the area of the metatarsophalangeal joint.The pathology code for hallux valgus according to ICD 10 is M20.1.
Main reasonHallux valgus disease is consideredhereditary weakness of connective tissue.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 guidelines for orthopedists use the following systematization of the stages of hallux valgus:
| Degree | Angle of deformation, in degrees | Signs of deformation |
| 1 (weak) | Less than 20 | Painless lump.Sometimes discomfort appears after a long walk. |
| 2 (average) | 25-35 | Severe 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 with choosing shoes, difficulty standing and walking, changes in gait.Frequent pain, 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 x-rays, which are taken in two projections with a load.Additionally, the doctor may prescribe plantography, CT, MRI, and other studies.
Surgery to correct Hallux valgus
Surgical treatment is indicated for moderate to severe hallux valgus deformity.At the request of the patient, 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 and others.
The intervention is carried out using the usual method or through percutaneous correction (using small punctures).It is possible to excise the growth 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.
At the initial stage of Hallux valgusthe operation lasts 30-40 minutes, with severe deformation –up to one and a half hours.
Rehabilitation after removal of Hallux valgus
Recovery after lump removal lasts about 2 months.The key to a complete recovery is strict adherence to the orthopedist’s recommendations.If the rules of rehabilitation are ignored, complications may develop in the long-term period after surgery - re-formation of hallux valgus or restriction of movements in the joints throughout life.
What shoes to wear after surgery
From the second day you are allowed to walk in Baruk's shoes.Before swelling decreases, you shouldmove around 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 a Baruk boot remains mandatory for 1-1.5 months after excision of the bone.Then you can wear loose sneakers or boots with wide toes.
You need to give up heels 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 lymph drainage, massage the entire lower part of the limb.The procedure begins with stroking.Then knead the sole and back of the foot in a circular motion.Grasp the ankle joint with your hands and move towards the knee.At the final stage, strokes are performed 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, held in each position for 10 seconds.Exercises are repeated 3-4 times a day.All movements are done carefully, avoiding discomfort.
From the second month after removal of Hallux valgus, the number of repetitions is increased to 7-8, the number of approaches - to 6-8 per day.Discomfort is acceptable.Active movements are complemented by passive ones (using hands).After a month and a half, you need to stand on your toes 5-6 times a day, 7-8 times, and maintain this position for about 10 seconds.
It is useful to walk on an inclined surface and climb stairs.
Corrective bandages
Corrective dressings 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 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 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 curvature.
To ensure resultstreatment should be started at the first signsappearance of hallux valgus.Special exercises, massage, physiotherapy, wearing orthopedic devices in combination with the use of folk remedies are effective.
Foot and big toe massage
The procedure is recommended to be carried out 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 turned inward.
- The sole is kneaded with a fist, alternately pressing on different areas in the distal part.
- Hallux valgus lump is massaged in a circular motion, then all fingers are stretched and kneaded.
- To stimulate the outflow of blood and lymph, wrap your arms around your leg and move your palms from the foot to the knee.
Medicines for deformity
To eliminate inflammation in the Hallux valgus area, topical anti-inflammatory drugs are used.
The formation of a 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, then washed off.
Can hallux valgus be corrected with exercises?
Exercises for Hallux valgus can strengthen ligaments and muscles and provide a positive effect on small bones.Therapeutic gymnastics is carried out after warming up the hallux valgus deformity using massage.Perform the following exercises:
- Alternately walking on your heels with support on the outer and inner edges of the foot.
- Walking on a suspendisse mat.
- Rolling an elastic ball.
- Extension and compression of the toes in a sitting position.
- Grabbing objects (pencils, napkins, small toys).
- Drawing various shapes in the air.
- Stretching the elastic band placed on the big toes by spreading the feet.
- Passive flexion and extension of the diseased joint using the hands.
The exercises are performed daily, completed with free stretching and stroking to relieve tension in the muscles.Only constant loads can affect the course of the disease.
Orthopedic devices
Taking into account 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, there are:
- Inter-finger inserts— correct the position of the first finger in the early stages of deformity or in the postoperative period.Made from soft silicone.
- Sole pads- soft products used to improve shock absorption.Sometimes they are 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
Physiotherapeutic 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- have the same effect as paraffin.Relieves muscle tension.
- Laser therapy— helps to 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 area of hallux valgus.
- Shock wave therapy— eliminates stagnant processes, stimulates blood flow, improves the delivery of oxygen and nutrients, and activates regeneration.Effectively acts not only on ligaments and muscles, but also on osteochondral tissue.
Prevention of hallux valgus
Prevention of Hallux valgus should begin early.Particular attention should be paid to the health of children's feet, whose family has relatives suffering from Hallux valgus with bumps on the thumbs.A bunion is formed when there is transverse flatfoot, so children and adults with this pathology need to regularly perform exercises to strengthen the ligamentum-musculus apparatus.
It is important to choose the right shoes - loose, with stable soles, made from natural materials.You should give up heels.It is useful to wear arch supports.If indicated, it is recommended to use orthopedic insoles.Regular, but not excessive, physical activity is beneficial.
You should get rid of excess weight to reduce static load.