Hallux Valgus: help with painful bale toe | Women's Health

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Do you love shoes as much? Beautiful shoes, high heels, shoes for every occasion. Appearance is often more important than wearing comfort. But then suddenly this unsightly big bump appears on the inside of the big toe and keeps getting bigger. The foot hurts, even in comfortable shoes. The hallux valgus, the technical term for this bunion, is a painful, stubborn companion. And it affects almost a quarter of all people, mostly women.

A woman could simply stop wearing heels as a preventive measure, that would be a step in the right direction. But shoes are not the only trigger of hallux valgus - and other preventive measures are also useful. With the help of an expert, we have collected information and tips as to why the toe moves in the first place and what you can do about it.

Hallux valgus, what is it?

Hallux valgus is the technical term for the most common malposition of the foot. The big toe leans strongly in the direction of the other toes, causing the ball of the toe to bulge outwards and the big toe twisting around its own axis. In extreme cases, the misalignment can assume an angle of up to 45 degrees. The resulting bump is often reddened by the friction and pressure in the shoe, and the bursa underneath can easily become inflamed.

Even if you have pain in the metatarsal area, it can be due to hallux valgus. This is because the big toe normally bears the entire body weight for a short time when rolling. A misalignment of the big toe means that the other four toes have to carry more weight.

Prof. dr medical Christina Stukenborg-Colsman, chief physician for foot and ankle surgery at the orthopedic clinic of the Hannover Medical School, describes it like this: "There is more stress on the small toes and their metatarsal heads, which in turn can lead to pain in the metatarsus." For non-medical people: The metatarsal heads are the front ends of the metatarsal bones.

Why do I get hallux valgus?

Anatomically, a shift in the metatarsal bone and also the metatarsophalangeal joint of the big toe is responsible for hallux valgus. In most cases, this is due to hereditary predisposition. Tight and high shoes with a pointed toe area can, but do not have to, promote hallux valgus. On the other hand, surprise: women suffer from this problem more often than men, ratio 9:1.

"Weak connective tissue and shortened calf muscles or Achilles tendon in combination with the deformity of hallux valgus can lead to overloading of the four outer metatarsal bones, and thus to the typical pain under the metatarsal, a so-called metatarsalgia," explains Stukenborg - Colsman.

Inflammatory joint diseases such as arthritis or rheumatism or if the foot is already burdened by other malpositions (most often it is accompanied by splayfoot) can promote hallux valgus and increase metatarsal pain.

How can I prevent hallux valgus?

In order not to get hallux valgus in the first place, it is advisable to wear comfortable shoes with enough space for the front foot area, or - and that's anyway much nicer and strengthens the foot muscles - to walk barefoot as much as possible. Unfortunately, you cannot really prevent hallux valgus. Here’s how you can prevent and reduce pain:

1. Running barefoot

Running barefoot on uneven ground provides more stimulation. According to Stukenborg-Colsman, sand and grass are the best options. But you have to start with that very early on: "If the big toe is already very deformed, or there are hammer toes and other malpositions of the toes that are no longer mobile, walking barefoot is often too painful." Here are even more good reasons to go barefoot more often.

2. Insoles and rolling aids

If the pain is too great, walking barefoot is no longer a solution. "Instead, shoes should be provided with bedding inserts and rolling aids in the area of ​​the footwear in order to relieve the foot here," says the expert. Good orthopedic insoles, custom-made for your feet, support and relieve your feet and help prevent pain. Incidentally, good insoles can also be made so finely that they nestle inconspicuously in pumps and ballerinas. Tip: You don't even have to go to an orthopaedist for this, you can now also order custom-made insoles online at craftsoles.de

3. Toe gymnastics / foot gymnastics

Exercises with a tennis ball or spiked ball have proven themselves. Also good: doing gripping exercises for mobility.

4. Training with fascia rollers and balls

This ensures that shortened muscles and fascia are sufficiently stretched. For example, there are also mini foam rolls especially for the feet - ideal for exercises under the desk.

How do I treat hallux valgus without surgery?

Various conservative measures help to keep the position of the big toe as central as possible and to stabilize the bone:

Char Moment / Shutterstock.comA night splint can relieve pain and keep bunions in the correct position.

Is hallux valgus irreversible?

If symptoms occur or worsen as bone displacement progresses, you can use a conservative treatment to reduce pain. However, the expert points out that in adulthood conservative methods cannot usually be expected to correct the deformity.

"Studies show that conservative therapy measures can only alleviate the concomitant diseases with the associated pain. However, conservative therapy measures cannot correct the deformity." Only an operation can then bring the toes back into their original position.

When should I have a hallux valgus operated on?

If the pain gets too bad, walking is restricted and conservative methods are no longer effective, a hallux valgus can be surgically removed. Especially with mild and moderate symptoms, the toes then stay in their natural position again and the pain has disappeared. The earlier hallux valgus is recognized and the earlier it is surgically corrected, the better the chances of success.

During the procedure, the length of the supporting tendons and ligaments is adjusted, the first metatarsal bone is broken and returned to its original position and stabilized with surgical screws. Ouch, yeah, that sounds nasty. However, a hallux operation is one of the relatively low-risk interventions. Stukenborg-Colsman advises having surgeries performed at foot centers because that's where the surgery is often performed and the surgeons there are the most experienced.

Nevertheless, surgery should never be underestimated and should only be the last option if non-surgical treatment techniques do not help. "In my opinion, no surgery should be performed for prophylactic or cosmetic reasons if you are symptom-free," Stukenborg-Colsman. Because if your hallux valgus isn't causing you any pain, you don't have to do anything about it.

Which shoes can I wear with hallux valgus?

If you immediately think of "orthopaedic insoles" and "support splints" of bulky health sandals with Velcro and foam soles: yes, they exist and no, classic hallux shoes Unfortunately, valgus shoes are really not the must-have for a stylish party night.

But there are now also suppliers who have specialized in modern health shoes, from boots and ankle boots to pumps, ballerinas, sandals and espadrilles through to stylish brogues. It's worth browsing!

If you want to prevent bunions as best and as long as possible, keep your foot muscles flexible and watch your shoes. And whenever possible, go barefoot!

Healthy livingHigh heelsHow to keep your feet pain-free and healthy despite wearing high heelsread moreSprainsHow to avoid twisting your ankles againread moreThis article may contain links to providers from whom Women's Health receives a commission. These links are marked with the following icon:13.09.2021Dana JansenTo the start page