Hallux valgus is a common orthopedic pathology.Usually treated surgically.Conservative methods - exercise therapy, massage, physiotherapy, medications - play an important role in the prevention and postoperative rehabilitation of hallux valgus.All methods of treating hallux valgus and big toe deviation will be discussed in the article.
What is Hallux valgus
This is a condition in which the big toe moves to the side and a bone appears at 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 walk in heels;
- excessive loads.
More rarely, hallux valgus deformity occurs due to developmental defects, injuries, or other diseases.
Hallux Valgus Degrees 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 stages of hallux valgus:
| Degree | Deformation angle, in degrees | Signs of deformation |
| 1 (low) | 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 recurrent inflammation of the joint. |
| 3 (heavy) | More than 35 | Severe deformity, problems choosing shoes, difficulty standing and walking, changes in gait.Frequent pain, calluses, corns and associated 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 early stages of deformation.Hallux valgus is treated by an orthopedist.
The main method for determining the degree of pathology is radiography, which is taken in two projections with a load.Additionally, the doctor may prescribe plantography, CT scan, MRI and other studies.
Surgery to correct hallux valgus
Surgical treatment is indicated in cases of moderate to severe hallux valgus deformity.At the patient's request, light surgical intervention 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 according to the usual method or by percutaneous correction (by 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, sometimes artificial fractures of the main phalanx or 1st metatarsal are created, the fragments are fixed with screws.
At the initial stage of Hallux valgusthe operation lasts 30 to 40 minutes, with significant deformation –up to one and a half hours.
Rehabilitation after removal of Hallux valgus
Recovery after removing lumps lasts about 2 months.The key to a full recovery is strict adherence to the recommendations of the orthopedist.If the rules of rehabilitation are ignored, complications may arise in the long term after surgery - reformation of hallux valgus or restriction of joint movements throughout life.
What shoes to wear after surgery
From the second day, you are allowed to walk in Baruk's shoes.Before the swelling goes down, you shouldmove as little as possible, most of the time, the patient lies with the leg elevated.After 2 weeks, walking restrictions are lifted.The use of a Baruk boot remains mandatory for 1 to 1.5 months after bone excision.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 an operation?
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 a circular motion.Grasp the ankle joint with your hands and move towards the knee.At the final stage, the blows are performed 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 bent and extended 3 times, held in each position for 10 seconds.The exercises are repeated 3 to 4 times a day.All movements are performed carefully, avoiding any 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 okay.Active movements are complemented by passive movements (with the hands).After a month and a half, you need to stand on tiptoes 5-6 times a day, 7-8 times, and hold this position for about 10 seconds.
It helps to walk on an inclined surface and climb stairs.
Corrective dressings
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 disrupts blood circulation and can cause soft tissue damage.
How to get rid of hallux valgus without surgery
In 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 guarantee resultstreatment should be started at the first signsappearance of hallux valgus.Special exercises, massage, physiotherapy, wearing orthopedic appliances 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 on the thigh of the other leg, with the sole facing inward.
- The sole is kneaded with the fist by pressing alternately on different areas of the distal part.
- The hallux valgus mass is massaged in a circular motion, then all fingers are stretched and kneaded.
- To stimulate the flow of blood and lymph, wrap your arms around your leg and move your palms from your foot to your knee.
Medicines against deformity
To eliminate inflammation in the Hallux valgus area, topical anti-inflammatory drugs are used.
The formation of hallux valgus is accompanied by the development of arthrosis and deterioration of local metabolic processes.Therefore, to improve blood circulation and stimulate tissue repair, drugs 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 based on 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?
Hallux valgus exercises can strengthen ligaments and muscles and have a positive effect on small bones.Therapeutic gymnastics is carried out after warming up the hallux valgus by massage.Perform the following exercises:
- Walk alternately on your heels with support on the outer and inner edges of the foot.
- Walk on a hanging mat.
- Roll an elastic ball.
- Extension and compression of the toes while seated.
- Grasp objects (pencils, napkins, small toys).
- Draw various shapes in the air.
- Stretch the elastic placed on the big toe by spreading your feet.
- Passive flexion and extension of the diseased joint using the hands.
Exercises are performed daily, supplemented by free stretching and stroking to relieve muscle tension.Only constant loads can affect the course of the disease.
Orthopedic devices
Considering the material, all Hallux valgus devices 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, we distinguish:
- Inter-finger inserts— correct the position of the index finger in the early stages of the deformity or in the postoperative period.Made of soft silicone.
- Soles- flexible 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 flexible or semi-rigid and support a significant part of the foot.They are also used for valgus feet.
- Orthopedic splints— adjust the hallux valgus angle.Used later and only at night, as they are incompatible with shoes.
Physiotherapy for Hallux valgus
Physiotherapeutic procedures are considered part of a comprehensive treatment and combine well with massage therapy 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 dilate 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 circulation, improves the supply of oxygen and nutrients and activates regeneration.Effectively acts not only on ligaments and muscles, but also on osteochondral tissue.
Hallux valgus prevention
Prevention of hallux valgus should start 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.A bunion is formed in case of transverse flatfoot, so children and adults with this pathology should regularly perform exercises to strengthen the ligamentous-muscular apparatus.
It is important to choose the right shoes - loose, with stable soles, made from natural materials.You should ditch the heels.It helps to wear arch supports.If indicated, it is recommended to use orthopedic insoles.Regular, but not excessive, physical activity is beneficial.
You need to get rid of excess weight to reduce static load.