Hallux valgus is a common orthopedic pathology.Usually treated surgically.Conservative methods - exercise therapy, massage, physiotherapy, medication - play an important role in the prevention and postoperative rehabilitation of hallux valgus.All treatment methods for hallux valgus and deviation of the big toe are discussed in the article.
What is hallux valgus?
This is a disease in which the big toe moves to the side and a bone forms in the area of the big toe joint.The pathology code for hallux valgus according to ICD 10 is M20.1.
Main reasonThe disease Hallux valgus is consideredHereditary connective tissue weakness.Provoking factors are:
- wear tight shoes;
- constant walking in heels;
- excessive loads.
Less commonly, hallux valgus deformity occurs due to developmental disorders, injuries, or other illnesses.
Dimensions of hallux valgus and their symptoms
There are different classifications of hallux valgus, distinguishing 3 or 4 degrees of pathology.The authors of the guidelines for orthopedists use the following systematization of the stages of hallux valgus:
| degree | Deformation angle in degrees | Signs of deformation |
| 1 (weak) | Less than 20 | Painless knot.Sometimes discomfort occurs after a long walk. |
| 2 (average) | 25-35 | Severe curvature, difficulty walking in shoes with heels and narrow toes.Possible pain, corns and recurring joint inflammation. |
| 3 (hard) | More than 35 | Severe deformity, problems choosing shoes, difficulty standing and walking, gait changes.Frequent pain, calluses, corns and accompanying changes to 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 taken in two projections under stress.In addition, the doctor may prescribe plantography, CT, MRI and other examinations.
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 to remove a node:
- exostosis resection;
- osteotomy;
- Tendon transfer according to McBride and others.
The procedure is carried out using the usual method or through percutaneous correction (using small punctures).There is an option 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 off, sometimes artificial fractures of the main phalanx or the 1st metatarsal are created, the fragments are fixed with screws.
In the early stages of hallux valgusThe operation takes 30-40 minutes, with strong deformation –up to one and a half hours.
Rehabilitation after removal of hallux valgus
Recovery after node removal takes approximately 2 months.The key to a full recovery is strict adherence to the orthopedist's recommendations.If the rehabilitation rules are not followed, complications such as the formation of a new hallux valgus or lifelong restriction of joint movement can occur in the long term after the operation.
What shoes do you wear after surgery?
From the second day you can walk in Baruk's shoes.Before the swelling goes down, you should do thisMove as little as possibleMost of the time the patient lies with his leg elevated.After 2 weeks the walking restrictions will be lifted.The use of a Baruk boot remains mandatory for 1-1.5 months after bone removal.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?
The massage can be performed 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 stroking.Then knead the sole and back of the foot in circular movements.Grasp the ankle joint with your hands and move toward the knee.In the final stage, strokes are carried out again.
Exercise therapy for feet with screws
Physiotherapy is a mandatory part of the rehabilitation period for hallux valgus and begins in the third week after surgery.First, the finger is flexed and extended three times and held in each position for 10 seconds.The exercises are repeated 3-4 times a day.All movements are carried out carefully to avoid discomfort.
From the second month after the removal of the hallux valgus, the number of repetitions increases to 7-8, the number of approaches to 6-8 per day.Complaints are 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 maintain this position for about 10 seconds.
It is useful to walk on an inclined surface and climb stairs.
Correctional associations
After removing the Baruk shoe, corrective bandages are used.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 impairs blood circulation and can lead to soft tissue injuries.
How to get rid of hallux valgus without surgery
In the advanced stage of hallux valgus, complete healing of the bunion through conservative correction is no longer possible.All conservative methods are intended solely to eliminate pain, prevent complications and the progression of the curvature.
To ensure resultsTreatment should be started at the first signsOccurrence of a hallux valgus.Special exercises, massage, physiotherapy, wearing orthopedic aids in combination with the use of folk remedies are effective.
Foot and big toe massage
It is recommended to carry out the procedure after a warm bath.
- The leg with the deformed toe is bent at the knee and placed with the sole of the foot inward on the thigh of the other leg.
- The sole is kneaded with the fist, alternately pressing different areas in the distal part.
- The hallux valgus lump is massaged in circular movements, then all fingers are stretched and kneaded.
- To stimulate the drainage of blood and lymph, wrap your arms around your leg and move your palms from foot to knee.
Medication for deformity
To eliminate inflammation in the hallux valgus area, topical anti-inflammatory drugs are used.
The development of a hallux valgus is accompanied by the development of osteoarthritis and a deterioration of local metabolic processes.Therefore, to improve blood circulation and stimulate tissue repair, drugs with a chondroprotective effect are used.
There are special complex ointments for 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 relieve pain and inflammation, you can use plasters, 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 exercises?
Exercises against 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:
- Alternating walking on heels with support on the outer and inner edges of the foot.
- Walking on a suspension mat.
- Roll an elastic ball.
- Extension and compression of the toes while sitting.
- Grasping objects (pencils, napkins, small toys).
- Draw different shapes in the air.
- Stretching the elastic band attached to the big toes by spreading the feet.
- Passive flexion and extension of the affected joint with the hands.
The exercises are carried out daily and supplemented with free stretches and strokes to relieve tension in the muscles.Only constant stress can influence 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 shoes are used to secure the foot at night.
Depending on the design, there are:
- Inserts between the fingers— Correct the position of the index finger in the early stage of deformity or in the postoperative period.Made from soft silicone.
- Sole padding- soft products to improve shock absorption.Sometimes they are available with a septum that eliminates the hallux valgus.
- Correctors and bandages— recommended for moderate and severe stages.They can be soft or semi-rigid and hold a large 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 not compatible with shoes.
Physiotherapy for hallux valgus
Physiotherapeutic procedures are considered part of a comprehensive treatment and are well combined with massage and exercise therapy.The following methods are used:
- Paraffin therapy— provides deep warming of the muscles and ligaments, improves blood circulation, activates local metabolism.
- Therapeutic mud- have the same effect as paraffin.Relieves muscle tension.
- Laser therapy– helps dilate capillaries, reduce swelling and improve protein absorption by cells.
- Ultrasound therapy- activates metabolism and microcirculation in the tissue.Stimulates collagen production.Reduces pain and swelling in the hallux valgus area.
- Shock wave therapy— eliminates stagnant processes, stimulates blood circulation, improves the supply 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 who suffer from hallux valgus with bumps on their thumbs.With transverse flat feet, a bunion occurs, so children and adults with this pathology need to regularly perform exercises to strengthen the ligament-muscular apparatus.
It is important to choose the right shoes - loose, with a stable sole, made of natural materials.You should avoid heels.It makes sense to wear arch supports.If indicated, the use of orthopedic insoles is recommended.Regular, but not excessive, physical activity is beneficial.
To reduce the static load, you should lose excess weight.