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HALLUX VALGUS GUIDE

Hallux valgus - Not only a women's problem

From UXGO
March 13, 2019, 4:19 pm

A large number of people suffer silently from hallux valgus pain. When the feet hurt or become unsightly deformed, the quality of life is suddenly rapidly reduced. Hiking in nature, standing for long periods at events or at work, everything becomes burdensome and uncomfortable. Thanks to excellent shoe innovations, those who want to maintain or improve their quality of life can still wear fashionable, comfortable and trendy shoes that are specially tailored to the needs of those affected.

Hallux valgus, also known as bunions, is one of the most common foot disorders in industrialized countries in a wide variety of forms and often brings with it unpleasant foot pain. Nikolaus Wülker and Frank Mittag published the following statement in the German Medical Journal in 2012: "No deformity (editor's note: deformation) of the forefoot is as common as hallux valgus. In a recent review, the global prevalence (frequency) is reported to be up to 23% in 18- to 65-year-olds and 35% in older people over 65."

Thus, along with back pain, the bunion is the secret common ailment of today's world. But what is hallux valgus anyway and how does it affect foot health?

Tips, exercises and home remedies against hallux valgus pain?
Click here to go directly to the specialist text about Hallux valgus pain relief!

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What is hallux valgus

Hallux valgus is a deviation of the big toe towards the neighboring toe. It looks as if the big toe leans over the next toe. As a result, the base joint of the big toe pushes outward and forms a bump on the foot. The transverse arch sinks due to this widening, and a splay foot often develops in addition. The toe joints are exposed to unfavorable tensile forces and stresses. The entire statics of the foot are thus thrown out of kilter.

Countries where wide shoes are still worn or barefoot walking is practiced have a lower rate of affected persons. Studies such as those by Sim-Fook and Hodgson (1958) show that the socially desired wearing of fashionable footwear led to a massive increase in hallux valgus and foot pain. The same development can be observed in Japan. There, the increase in hallux valgus and the introduction of "modern" shoes also ran parallel, as Kato and Watanabe pointed out in their 1981 study.

Nevertheless, the deformity is not only a homemade problem.

A genetic-familial predisposition is among the most common causes, along with shoe choice. There seems to be a tendency for hallux valgus patients affected by foot pain to become younger and younger: high heels and tight shoes are being consumed by young people at an increasingly early age and - just like obesity and too little exercise - have a negative effect on foot muscles and foot position.

Let's turn to the causes of hallux valgus.
How does it actually develop?


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Viele Faktoren begünstigen die Entstehung von Hallux valgus:

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1. Beschaffenheit des Bindegewebes

2. Erblich bedingte Veranlagung

3. Abschwächung der Fußmuskulatur

4. Medikamente

5. Schwangerschaft

6. Häufiges Stehen

7. Rheuma

8. Spreizfußfehlstellung

9. Falsches Schuhwerk

10. Selten: Traumata / Verletzungen

Hallux valgus causes

What would women be without their shoes?

Shoes mean much more than footwear to many women. They are a status symbol, a figurehead, and have collector's value. But does it really make sense to deform one's feet just to fit into a certain pair of shoes and look "beautiful"? More and more women are freeing themselves from this, living a healthy body image again and being more mindful of themselves and their bodies.

Elisabeth R. is 45 years old, she is adventurous, fashion and health conscious and has been suffering from hallux valgus-related foot pain for years: "I used to be ashamed of my ugly feet, but now I know that so many women have hallux valgus that it is almost normal. Since I have to wear fancy shoes and clothes because of my job, this was actually the bigger problem: passable footwear that didn't look old-fashioned wasn't to be found for a long time." Elisabeth tortured herself day in and day out with shoes that were too tight, because she didn't want to look out of place.

That was the final straw, so that a hallux valgus operation became unavoidable. Many women feel the same way as Elisabeth. That's why it's important, especially if you have a family history of hallux valgus, to strengthen your foot muscles in good time and to wear shoes that are wide enough to slow down the development of hallux valgus.

You want to know more about the hallux valgus causes?
Click here to go directly to the article Causes of hallux valgus!

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Symptoms and diagnostics of hallux valgus

The good news first: not every hallux, no matter how severe, has to be painful!

Many women can walk without foot pain despite a severe deformity. But the other way around, a less pronounced big toe deformity may cause severe foot pain. Actually, you can say you are lucky if it is "only" a cosmetic problem and not a very painful one!

Depending on the severity, the hallux angle and thus the curvature of the metatarsophalangeal joint of the big toe also varies. So the sooner you take the appropriate measures and wear proper hallux valgus shoes, the sooner you can avoid a small problem becoming a big one, which can cause you severe pain and problems when walking.


Symptoms

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  • Deviation big toe
  • Lowering of the transverse arch of the foot
  • Bunion painful and reddened
  • Irritation of the big toe
  • Risk of arthrosis
  • Inflammatory processes
  • Hammer toe or claw toe

Swelling, pressure pain and redness can also be symptoms of the bunion.

Classic symptoms of hallux valgus

 

Hallux valgus is often preceded by splayfoot.

Here, as the name suggests, the transverse arch spreads apart and becomes flatter. The forefoot widens and the metatarsal bones involved are thus exposed to massive stress. Foot pain can develop. Splayfoot is usually treated with insoles, physical therapy and, if necessary, anti-inflammatory medications. A bulge on the inside of the foot, due to the lateral shifting of the big toe towards the middle toe, indicates an incipient deformity.

In addition to visual manifestations such as the big toe deviating toward the middle toe, there is also an imbalance of the foot muscles and ligaments. The holding apparatus of the foot no longer functions properly because the balance of forces is disturbed.

If hallux valgus manifests itself painfully, pain at the ball of the foot is in the foreground because the metatarsal arches outward and is exposed to increased stimuli. Foot pain can be triggered not only by pressure from the outside, but also from the inside. For example, bursitis can bring severe foot pain. The triggered imbalance of the foot muscles also promotes the development of hammer toe or claw toe.

You want to know more about the symptoms?
Click here to go directly to the article about Hallux valgus symptoms.

Learn more

 


Severity and diagnostics

 

After an assessment, the treating physician can often already make a diagnosis. In addition, the X-ray image provides information about the exact deformity, the stage of the deformity and the condition of the metatarsophalangeal joint of the big toe. However, it does not provide information about the severity of the foot pain.

The severity of hallux valgus is usually divided into 3 degrees of severity. Individual symptoms may vary depending on the severity:

Grade 1: The hallux angle is less than 30° degrees, usually there is no discomfort. Rarely, there may be pressure points and redness. Sometimes foot pain can already be felt when walking. Now it would be important to do foot gymnastics and walk barefoot a lot. In addition, orthopedic insoles can be used when standing.

Grade 2: The angle is between 31°-40°. Complaints such as pressure or bunion pain may occur. Prolonged standing and walking can lead to foot pain. Targeted strengthening of the foot muscles is also useful at this point. Orthopedic aids provide relief.

Grade 3: If the angle is over 40°, severe foot pain and deformation of the big toe may occur. In addition, bursitis can cause severe pain. There is pressure pain and redness. A medical solution should be found in consultation with the doctor. A hallux valgus surgery is the last step, before that intensive work should be done with a physiotherapist.

The doctor measures two angles on the X-ray for diagnosis:

1. hallux valgus angle.

Also abbreviated HVA or hallux valgus angle. The hallux valgus angle describes the lateral (sideways) deviation of the big toe.

2. intermetatarsal angle

Also called IMA-I/II. Standing load recording so that the angle between the 1st and 2nd metatarsal can be correctly determined.

 

ANGLE DESIGNATION
LIGHT
MEDIUM
HEAVY
ANGLE DESIGNATION:

Intermetatarsal angle

LIGHT:

11-15°

MEDIUM:

16-20°

HEAVY:

>20°

ANGLE DESIGNATION:

Hallux valgus angle

LIGHT:

21-30°

MEDIUM:

31-40°

HEAVY:

>40°


What you can do in between against your hallux:

  • Massage the foot with a hedgehog ball to activate it
  • Walk barefoot on different surfaces (grass, earth, stone)
  • Fold a newspaper with your feet
  • Pick up objects with your feet

Hallux valgus treatment

 

Since weakened foot muscles - or an imbalance of the muscles - usually play a major role in the development of hallux valgus, strengthening the foot muscles is a priority in prevention. Even young children should walk barefoot as often and as much as possible.

Today's trend towards barefoot shoes (also for sports) also has a positive effect on the foot muscles.

Thus, the foot muscles have enough stimuli to develop well and to stabilize the foot skeleton. Special physiotherapy, which promotes targeted strengthening of the foot muscles, can also be used. However, if the hallux is already present, it is imperative to pay attention to suitable footwear. However, there are also some simple exercises that can be integrated into everyday life. You can find suggestions in the adjacent info box.

Especially if you are overweight, exercises to strengthen the foot muscles and hallux valgus gymnastics are particularly recommended, as the arch of the foot is usually subjected to excessive strain.


Orthopedic aids & hallux valgus shoes

 

If the symptoms are pronounced and foot pain is commonplace, adapted orthopedic aids such as hallux valgus bandages, hallux valgus insoles, toe spreaders and hallux valgus splints can be used for short-term relief.

There is no effective treatment that "pulls" a bunion toe back to its original position. Minimal skeletal adjustment is possible only in childhood, when the bones are not yet fully formed.

Wide shoes can lead to freedom from pain, as bursae and pressure points are less irritated.

Here, our UXGO shoes offer a solution that is also visually appealing, thanks to the "UXGO last with V-effect". This shoe shape is based on the natural V-shape of the feet, giving generous space to the forefoot and still plenty of support at the heel. Wearing a Hallux splint is no problem. Only if the forefoot has space and the friction of the hallux valgus on the shoe is minimized, internal and external inflammations can be prevented.

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Hallux valgus surgery

 

However, if the foot pain is unbearable, surgical correction offers a solution.

Here, primarily chronic hallux valgus pain and mobility restrictions are indicators for surgery. In the case of constant foot pain and a noticeable impairment of function, orthopedists advise surgery. The costs are covered by health insurance if the diagnosis is appropriate. Purely cosmetic interventions are usually not covered by statutory health insurance.

The correction of the bunion toe is based on the radiologically recorded angle.

The aim of hallux valgus surgery is to correct the position of the metatarsophalangeal joint of the big toe and to prevent further changes that could damage the joint. Which of the different surgical procedures (common are e.g. Meyer/Scarf, Lapidus or Austin/Chevron) helps with your foot pain is decided individually by the treating orthopedist. In most cases, hallux valgus surgery is performed according to similar principles: 1. correction of tendons and joint capsule so that the big toe bones can be straightened. 2. big toe bone is aligned so that the toe looks forward again. If there is a large joint damage and foot pain due to osteoarthritis, the ankle can be conserved or stiffened during hallux valgus surgery.

Surgery is always a procedure with risks and should be well considered and not performed hastily. The Hallufix® insole prescribed after hallux valgus surgery fits perfectly into UXGO shoes, at shoe width H.


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Conclusion

 

Hallux valgus is a common condition with an increasing tendency. Younger and younger women complain about foot pain and deformation of the toes. In addition to genetic factors, a dysbalance of the musculature as well as poor or unsuitable shoes play an important role in the development. Preventive measures include shoes with sufficient toe clearance, lots of barefoot walking and strengthening the foot muscles. You can find tips and exercises for hallux valgus gymnastics in the article "Alleviating pain".

Hallux valgus symptoms can be treated and relieved with a combination of physical therapy and orthotic devices. Surgery should be considered last. Basically, walking barefoot a lot and from childhood promotes the healthy development of the feet, in addition, foot exercises can be a good and easy means of prevention.

Important Notice:

This article contains general information only and should not be used for self-diagnosis or self-treatment. It cannot replace a visit to the doctor. If you have symptoms and foot pain, make an appointment with an orthopedist, preferably a podiatrist.

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