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Hallux valgus causes

from UXGO
28 August 2018, 9:19 a.m.

When women over forty are asked what causes them major physical problems, many spontaneously think of their feet. You may know it yourself: In the past, you could slip into almost any shoe and dance until the morning hours.

Okay, let's face it, the foot used to hurt, but after a day everything was forgotten again. Or after a strenuous hike the feet were tired: shoes off, off into the creek, nice cooling - and on we went. Today, the foot is already hurting without any particular strain, simply because of its deformity. And that, understandably, limits many people in their lives. It prevents activities. It struggles to avoid withdrawing from many areas of social life.

Christina is doing fitness classes today instead of standard dancing:
That's what Christina says: „I always liked standard dancing, but at some point I had such a footache that it couldn't be done otherwise: I had to stop. That was terrible. But dancing on the high shoes just hurt too much. Today I go to the gym and like to take part in classes - and it works flawlessly. It wasn't easy to accept that the dancing was over, but today I feel much better!“ 

External Hallux valgus causes

  • overweight
  • Narrow, pointed, high shoes
  • traumas
  • medications

Inner Hallux valgus Causes

  • Genetic factors, such as structure of connective tissue and foot
  • Thereby imbalance and downturn of musculature and ligamentous apparatus
  • Incomplete loading due to splayfoot
  • Diseases of inflammation

What are Hallux valgus causes and what causes this foot malposition?

Hallux valgus is one of the most common malpositions of the females. It occurs predominantly in female patients over the age of 40. Many factors contribute to the development of hallux valgus, therefore one speaks of multifactorial hallux valgus causes.

Factors such as the anatomy of the foot and the tensile strength of the connective tissue play a role in the development of hallux valgus. Women in particular are often affected by weak connective tissue. Hallux valgus patients are therefore predominantly female. Since connective tissue weakness is often inherited, Hallux valgus can occur in families.

Why does a lax connective tissue contribute to the hallux valgus causes?

If the tissue is too weak, it will not be able to lift the foot against the body weight. Systemically, this results in a sinking of the transverse tissue and an incorrect loading of the surrounding structures such as the tendons, joints and bones. Pregnancy can also have an influence on the development of a bunion and is one of the hallux valgus causes. It is precisely during this time that the connective tissue becomes soft and flexible. Inflammatory diseases such as rheumatism often have a negative effect on foot statics and add to the Hallux valgus causes.

Another clinical picture that favors Hallux valgus is rheumatoid arthritis. It manifests itself with pain and stiffness of the foot. The gait pattern then changes, leading to the formation of calluses, horn eyes or hallux valgus. Poliomyelitis or arthrosis also cause hallux formation.

Even so external influences such as obesity, trauma, medication and high heels add to the hallux valgus causes. Despite family frequency, no human is born with hallux valgus. One must therefore assume that mechanical influences, such as wrong footwear or other environmental influences, initiate the development of hallux valgus.

Anatomical Hallux valgus Causes

Let's take a close look at the anatomical structure of the foot so that we understand exactly what is meant by the axial deviation from the definition and what are the causes of Hallux valgus:

The German Society for Orthopedic and Orthopedic Surgery (DGOOC), with lead author H. Waizy, defines hallux valgus as:

„The hallux valgus is a malposition of the big toe with an axial deviation to fibular (valgus) and a simultaneous axial deviation of the metatarsal I to tibial (varus).“

Figure 1:

The 1st figure shows a foot without hallux valgus, it is clearly visible that the foot is stable, the big toe looks straight upwards and the metatarsal joints (metatarsal I-IV) are aligned with the articular surface.

Figure 2:

The 2nd figure shows a hallux valgus and now the anatomical hallux valgus causes become visible: The metatarsal bones are pressed into width by the widened and lowered transverse tissue of the foot. As a result, they no longer fit exactly in the articular surface.


Change of tendons

For the deformation of the toe can be connective tissue, high weight, tight or high heeled shoes. The foot can no longer perform its function of absorbing (i.e. intercepting) stumps sufficiently. The tendons of the muscles Extensor Hallucis Longus (extensor), Flexor Hallucis Longus (flexor) and of the abductor and adductor Hallucis are in imbalance. They continue to pull and stabilize, but the tendon cord and the big toe are at an angle and no longer parallel to each other.

The sequence:

This causes the big toe to fold and a bunion, also called hallux valgus, develops. Now the anatomical causes of hallux valgus are clearly visible: A three-dimensional axial malalignment is present due to static partial dislocation of the first metatarsophalangeal joint. The further the hallux valgus malposition progresses, the more difficult it becomes to compensate the malposition by pure muscle pull and physiotherapy. Internal hallux valgus causes as well as external hallux valgus causes lay the foundation for this deformation.

Barefoot walking from childhood on would be beneficial for all those affected who suffer from hallux valgus mainly due to environmental influences. Hereditary Hallux valgus causes can only be influenced to a limited extent by systematic strengthening of the foot muscles. Strong foot muscles nevertheless seem to play a major role in prevention. Our gait cycle with its various phases is designed to exercise locomotion economically and to protect internal organs and the brain through shock absorption. A good weight distribution over the foot plays an important role here.

By wearing shoes that are too tight, pointed and high, this weight distribution becomes unbalanced. Rolling over the heel does not take place. The shocks, which the heel should first absorb, directly load the forefoot. In addition, the metatarsal bones carry the whole body weight when rolling. Heel shoes mean that the weight is no longer distributed on the foot, but mainly on the transverse arch of the foot. This can hardly stand up to it and weakens more and more. The foot becomes wider at the front and the shocks less and less absorbed.


Wrong shoes and their effects

If an imbalance has arisen due to “wrong footwear“ and if such a splayfoot or even hallux valgus has developed, the effects on the metatarsophalangeal joint become increasingly massive. The flatter the foot becomes, the more the load increases. This results in a rolling behaviour when walking, which also increases the load on the metatarsus. A redistribution of the weight to the neighbouring toes that are not laid out for this purpose occurs. Foot pain and other malpositions can result from this circulation.

Read more about symptoms and diagnostics here?
Go directly to the article Symptoms of Hallux valgus

learn more 

Do I already have a splayfoot?

  • Slumped foot (flat foot)
  • sunk toesöpfchen
  • Widening of the forefoot
  • Calluses on the forefoot


Problem Splayfoot – Hallux valgus Causes


The splayfoot belongs to the typical forelegs of the hallux valgus and to the hallux valgus causes.

A splayfoot is often caused by overweight, lax connective tissue, tight, high shoes – rarely by accidents. Splayfoot and Hallux valgus Causes are almost always based on an Attenuation of the foot muscles.

Initially, a splayfoot can only be diagnosed with foot pressure measurement (pedobarography also podometry). Here the exact distribution of the weight is made visible during the occurrence and the rolling movement. The procedure uses the footprint to provide information about the situation of the joints, tendons and soft tissues. If the transverse arch of the foot sinks further and there is a deviation of the big toe to the outside and possibly a displacement of the metatarsal bone, the splayfoot becomes a hallux valgus.

Our tip:

Barefoot! It is important not only to run with insoles. The insoles support the foot, but they also relieve it of its work. The foot muscles weaken even more. Just as it also belongs to Hallux valgus causes, shoe fashion seems to play a major role in the development of the splayfoot.

Shoe fashion - important factor of Hallux valgus causes


Uncomfortable shoes are of course also among the Hallux valgus causes.

If you want to be beautiful, you have to suffer! Really? Today so many women spend so much money on shoes, why should women have to do without a certain comfort? Because "Where does the shoe pinch" - "Somehow everywhere" - takes so much quality of life. UXGO shoes are fashionable, comfortable and casual. So nothing for quitters. And they do not belong to the Hallux valgus causes.

From time to time also beautiful shoes can be worn

Of course, high heels can still be worn for a nice evening in the theatre, for eating out or dancing! Even if they belong to the Hallux valgus causes. It becomes problematic, if daily and for hours shoes with heel are carried. The trend towards heels in children's fashion is also very problematic; even primary school children can wear boots or sandals with heels. Especially in a phase in which the foot skeleton is still soft and adaptable, this is very questionable and counterproductive for the development of a healthy foot. In the future there will certainly be another Hallux valgus cause to be found here.

A varied range of shoes and running without shoes prevent the formation of hallux valgus in the long term. Good, high-quality and sufficiently wide shoes are not hallux valgus causes!

Read more about pain relief and treatment!?
Here you can go directly to the article Treatment of Hallux valgus

learn more 


Hallux valgus causes - Conclusion


The Hallux valgus causes are manifold. One can distinguish between external Hallux valgus causes and internal Hallux vaglus causes. External Hallux valgus causes are for example oppressive shoes and overweight. Internal Hallux valgus causes are the weakening of the muscles or deformations in the foot. One of the main causes is a weak connective tissue and thus a hereditary frequency within families. Another cause is the resulting weakening and atrophy of the foot muscles. If these muscular stabilizers are missing, the entire anatomical balance is lost. The resulting shifts lead to misalignment and overloading of the adjacent structures. One consequence is often the splayfoot, which is caused by the sunken arch of the foot and is considered to be a precursor of the hallux valgus.

Do not save on good footwear!

Also the shoe fashion as Hallux valgus cause should not be underestimated! Studies show again and again that with the introduction of western shoe ideals and shoe models more Hallux valgus complaints occur. With increasing age, foot health becomes more and more important. The right footwear is immensely important to counteract hallux problems or other deformations of the feet. External Hallux valgus causes can be influenced, internal Hallux valgus causes are difficult to eliminate without medical intervention.

Important note:

This article is for general guidance only and should not be used for self-diagnosis or self-treatment. It cannot replace a visit to the doctor. If you experience hallux valgus foot pain, make an appointment with an orthopaedic surgeon, preferably a podiatrist.