Hallux valgus is a common orthopedic pathology.It is usually treated surgically.Conservative methods - exercise therapy, massage, physiotherapy, drugs - 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 pathological code of hallux valgus according to ICD 10 is M20.1.
Main reasonIt refers to the disease of hallux valgushereditary weakness of the connective tissue.Provocative factors are:
- wearing tight shoes;
- constant walking on heels;
- excessive loads.
Less commonly, hallux valgus deformity occurs due to developmental defects, injuries, or other illnesses.
Degrees of Hallux Valgus and their symptoms
There are several classifications of Hallux valgus, which distinguish 3 or 4 degrees of pathology.Authors of guidelines for orthopedists use the following systematization of the stages of hallux valgus:
| Degree | Angle of deformation, in degrees | Signs of deformation |
| 1 (weak) | Less than 20 | A painless lump.Sometimes discomfort appears after a long walk. |
| 2 (medium) | 25-35 | Severe curvature, difficulty walking in shoes with heels and narrow toes.Possible pain, calluses and recurrent inflammation of the joint. |
| 3 (severe) | More than 35 | Severe deformity, problems choosing shoes, difficulty standing and walking, changes in gait.Frequent pains, calluses, calluses and accompanying changes in the foot are characteristic. |
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 initial stages of deformation.Hallux Valgus is treated by an orthopedist.
The main method for determining the degree of pathology is X-rays, which are made in two projections with a load.In addition, the doctor can prescribe plantography, CT, MRI and other studies.
Surgery to correct Hallux valgus
Surgical treatment is indicated for moderate to severe hallux valgus deformity.At the request of the patient, a minor operation is sometimes performed to remove a cosmetic defect.There are many methods to remove a lump:
- resection of exostosis;
- osteotomy;
- tendon transfer according to McBride et al.
The intervention is carried out by the usual method or by percutaneous correction (through small punctures).Excision of the growth with a laser is possible.One or more incisions are made on the side or back of the leg.The cone is cut off, sometimes artificial fractures of the main phalanx or 1st metatarsal bone are created, the fragments are fixed with screws.
In the initial stage of Hallux valgusthe operation lasts 30-40 minutes, with strong deformation –up to an hour and a half.
Rehabilitation after removal of Hallux valgus
Recovery after removal of the lump lasts about 2 months.The key to full recovery is strict adherence to the orthopedist's recommendations.If the rules of rehabilitation are neglected, complications may develop in the long term after the operation - re-formation of hallux valgus or limitation of movements in the joints throughout life.
What shoes to wear after surgery
From the second day you are allowed to walk in Baruch's shoes.Before the swelling goes down, it shouldmove as little as possible, most of the time the patient lies with the leg elevated.After 2 weeks walking restrictions are removed.The use of a Baruk boot remains mandatory for 1-1.5 months after bone excision.Then you can wear loose sneakers or wide-toed boots.
You must give up heels for six months.
Is massage possible after surgery?
Massage can be done after complete healing of the wound.To improve blood circulation and lymphatic drainage, massage the entire lower limb.The procedure begins with stroking.Then knead the foot and the back of the leg 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
Physical therapy is a mandatory part of the hallux valgus rehabilitation period and begins on the third week after surgery.First, the finger is bent and stretched 3 times, holding in each position for 10 seconds.The exercises are repeated 3-4 times a day.All movements are performed carefully, avoiding discomfort.
From the second month after the removal of Hallux valgus, the number of repetitions increases to 7-8, the number of approaches - to 6-8 per day.Discomfort is acceptable.Active movements are complemented by passive ones (with hands).After a month and a half, you should 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.
Corrective bandages
Corrective dressings are used after the use of the Baruk shoe is stopped.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 an advanced stage of hallux valgus, it is impossible to completely cure the bunion by 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 signsoccurrence of hallux valgus.Special exercises, massage, physiotherapy, wearing orthopedic devices in combination with the use of folk remedies are effective.
Foot and big toe massage
The procedure is recommended to be performed 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 a fist, successively pressing different areas in the distal part.
- The Hallux valgus lump is massaged with circular movements, after which all fingers are stretched and kneaded.
- To stimulate the flow of blood and lymph, wrap your arms around your legs and move your palms from the foot to the knee.
Medicines for deformity
To eliminate inflammation in the area of Hallux valgus, local anti-inflammatory agents are used.
The formation of hallux valgus is accompanied by the development of arthrosis and deterioration of local metabolic processes.Therefore, to improve blood flow and stimulate tissue recovery, 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, relieve pain and stimulate tissue regeneration.
To reduce 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, then washed.
Can hallux valgus be corrected with exercise?
Exercises for Hallux valgus can strengthen the ligaments and muscles and provide a positive effect on the small bones.Therapeutic gymnastics is performed after warming up the hallux valgus deformity with the help of massage.Do the following exercises:
- Alternate heel walking with support on the outer and inner edge of the foot.
- Walking on a suspension mat.
- Rolling an elastic ball.
- Extension and contraction of the toes in a sitting position.
- Grabbing objects (pencils, napkins, small toys).
- Drawing different shapes in the air.
- Stretching the elastic band placed on the big toes by spreading the feet.
- Passive flexion and extension of the affected joint using the hands.
Exercises are performed daily, finished with free stretching and stroking to relieve muscle tension.Only constant loads can affect the course of the disease.
Orthopedic devices
Depending on the material, all devices for Hallux valgus are divided into three groups: soft, semi-rigid, rigid.The soft ones are used during the day, the semi-hard ones - up to several hours.The hard ones are designed to secure the foot at night.
Depending on the type of construction, there are:
- Interfinger inserts— correct the position of the first finger in the early stages of deformity or in the postoperative period.Made of soft silicone.
- Soles for soles- soft products used to improve shock absorption.Sometimes they come with a septum that eliminates hallux valgus.
- Concealers and bandages— recommended for moderate and severe stages.They can be soft or semi-rigid and hold a significant portion of the leg.They are also used for valgus feet.
- Orthopedic splints— adjustment of the hallux valgus angle.They are used in the later stages and only at night, as they are incompatible with shoes.
Physiotherapy for Hallux valgus
Physiotherapy procedures are considered part of the complex treatment and combine well with massage and physical therapy.The following methods are used:
- Paraffin therapy— provides deep warming of muscles and ligaments, improves blood circulation, activates local metabolism.
- Healing mud- have 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— removes stagnant processes, stimulates blood flow, improves the supply of oxygen and nutrients, activates regeneration.Effectively acts not only on ligaments and muscles, but also on osteochondral tissue.
Prevention of hallux valgus
Hallux valgus prevention should start early.Particular attention should be paid to the health of children's feet, whose family has relatives suffering from hallux valgus with bumps on the big toes.A bunion is formed when there is a transverse flat foot, 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 of natural materials.You have to give up the heels.It is helpful to wear arch supports.In case of indications, the use of orthopedic insoles is recommended.Regular but not excessive physical activity is beneficial.
You need to get rid of excess weight to reduce static load.