Hallux valgus is a common orthopedic pathology.It is 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 treatment of 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 connective tissue weakness.The provoking factors are:
- wear tight shoes;
- constantly walking in heels;
- excessive loads.
Less commonly, hallux valgus deformity occurs due to developmental defects, injuries, or other diseases.
Degrees of Hallux Valgus and its symptoms
There are several classifications of Hallux valgus, which distinguish 3 or 4 degrees of pathology.The authors of guides 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 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, calluses and recurrent inflammation of the joint. |
| 3 (heavy) | More than 35 | Severe deformity, problems choosing footwear, difficulty standing and walking, changes in gait.Frequent pain, corns, calluses 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 mainly used in the initial stages of deformation.Hallux Valgus is treated by an orthopedist.
The main method of determining the degree of pathology is x-rays, which are taken in two projections with one load.Additionally, the doctor may prescribe plantography, computed tomography, MRI and other studies.
Surgery to correct Hallux valgus
Surgical treatment is indicated for moderate to severe hallux valgus deformity.At the patient's request, minor surgery is sometimes performed to eliminate a cosmetic defect.There are many methods to remove a lump:
- exostosis resection;
- osteotomy;
- tendon transfer according to McBride et al.
The intervention is carried out using the usual method or by percutaneous correction (using small punctures).It is possible to remove the growth with a laser.One or more incisions are made in the side or back of the foot.The cone is cut, sometimes artificial fractures of the main phalanx or the first metatarsal bone are created, and the fragments are fixed with screws.
In the initial stage of hallux valgus.the operation lasts 30-40 minutes, with severe deformation –up to an hour and a half.
Rehabilitation after removal of Hallux valgus.
Recovery after removal of the lump lasts approximately 2 months.The key to a complete recovery is strict compliance with the orthopedist's recommendations.If the rehabilitation rules are ignored, long-term complications may develop after surgery: new formation of hallux valgus or restriction of movements in the joints for life.
What shoes to wear after surgery?
Starting on the second day you will be 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 Baruk boots remains mandatory for 1-1.5 months after bone excision..Then you can wear loose sneakers or boots with a wide toe.
You should leave the heels off for six months.
Is it possible to have a massage after surgery?
The massage can be done 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 motions.Hold the ankle joint with your hands and move towards the knee.At the final stage, strokes are made again.
Screw foot exercise therapy.
Physiotherapy is a mandatory part of the Hallux valgus rehabilitation period and begins in the third week after surgery.First, you bend and extend your finger 3 times, holding it in each position for 10 seconds.The exercises are repeated 3-4 times a day.All movements are done carefully, avoiding discomfort.
Starting from the second month after the removal of hallux valgus, the number of repetitions increases to 7-8, the number of approximations - 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 should stand on your toes 5-6 times a day, 7-8 times and hold this position for about 10 seconds.
It is helpful to walk on an inclined surface and climb stairs.
Corrective bandages
Corrective dressings are used after you stop wearing the Baruk shoe.The products consist of two bandages connected by a hinge and fix the thumb in an abducted 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 signs.appearance of hallux valgus.Special exercises, massage, physiotherapy and the use of orthopedic devices 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 turned inward.
- The sole is kneaded with the fist, pressing alternately on different areas of the distal part.
- The hallux valgus lump is massaged in circular movements, then all the fingers are stretched and kneaded.
- To stimulate the outflow of blood and lymph, put your arms around your leg and move your palms from your foot to your knee.
Medications for 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 osteoarthritis and deterioration of local metabolic processes.Therefore, medications with chondroprotective effects are used to improve blood flow and stimulate tissue repair.
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, patches, compresses with propolis, burdock and turpentine, red clay and sea salt can be used.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 for 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 by massage.Perform the following exercises:
- Walk alternately on the heels with support on the outer and inner edges of the foot.
- Walking on a suspended mat.
- Roll an elastic ball.
- Extension and compression of the toes in a sitting position.
- Grab objects (pencils, napkins, small toys).
- Draw various shapes in the air.
- Stretch the elastic band placed on the big toes, separating the feet.
- Passive flexion and extension of the diseased joint using the hands.
The exercises are performed daily and are 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 Hallux valgus devices are divided into three groups: soft, semi-rigid and hard.The soft ones are used during the day, the semi-hard ones - up to several hours.The rigid ones are designed to support the foot at night.
Depending on the type of construction, there are:
- Insertions between fingers— correct the position of the index finger in the early stages of the deformity or in the postoperative period.Made of soft silicone.
- Templates- 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 support an important part of the foot.They are also used for valgus feet.
- orthopedic splints— adjust the angle of the hallux valgus.They are used in later phases and only at night, since they are incompatible with footwear.
Physiotherapy for hallux valgus
Physiotherapeutic procedures are considered part of a comprehensive treatment and combine well with massage and exercise therapy.The following methods are used:
- Paraffin therapy— provides deep warming of muscles and ligaments, improves blood circulation and activates local metabolism.
- therapeutic mud- has the same effect as paraffin.Relieves muscle tension.
- laser therapy— helps 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 hallux valgus area.
- Shock wave therapy— eliminates stagnant processes, stimulates blood flow, improves the supply of oxygen and nutrients and activates regeneration.It acts effectively not only on ligaments and muscles, but also on osteochondral tissue.
Hallux valgus prevention
Prevention of Hallux valgus should start 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 the thumbs.A bunion is formed when there is a transverse flat foot, so children and adults with this pathology need to perform regular exercises to strengthen the ligamentous-muscular apparatus.
It is important to choose the right shoes: loose-fitting, with stable soles and made of natural materials.You should put down your heels.It is helpful to use 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 charge.