Hallux Valgus, 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.The article will discuss all the treatment methods for Hallux Valgus and deviation of the big toe.
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.According to ICD 10, the pathology code for Hallux Valgus is M20.1.
The main reasonHallux Valgus is considered a diseaseHereditary weakness of connective tissue.Contributing factors:
- Wearing tight shoes;
- Constant walking in heels;
- Excessive loads.
Less often, hallux valgus deformity occurs due to developmental defects, injuries or other diseases.
Degrees of Hallux Valgus and their symptoms
There are several classifications of hallux valgus, distinguishing 3 or 4 degrees of pathology.The authors of the guidelines 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 | A piece without pain.Sometimes anxiety causes discomfort after a long walk. |
| 2 (medium) | 25-35 | Difficulty walking in shoes with severe curvature, ankle and narrow toes.Possible pain, corns and repeated recurrent inflammation. |
| 3 (heavy) | More than 35 | Severe deformity, problems choosing shoes, standing and walking, changes in gait.Frequent pain, ringing, corns and changes in the foot are typical. |
Treatment of Hallux Valgus Defority of the First Foot
The only way to correct severe Hallux Valgus is surgical correction.Conservative techniques are mainly used in the early stages of deformation.Hallux valgus is treated by an orthopedist.
The main method for determining the degree of pathology is X-rays taken in two projections with one charge.In addition, the doctor can prescribe plantography, CT, MRI and other studies.
Surgery to Correct Hallux Valgus
Surgical treatment is indicated for moderately severe hallux valgus deformity.At the request of the patient, a mild operation is sometimes performed to eliminate the cosmetic defect.There are many methods to extract a piece:
- Exostosis resection;
- osteotomy;
- Tendon transfer according to McBride et al.
The intervention is carried out using the usual method or percutaneous correction (using a small puncture).It is possible to excise the growth with a laser.One or more incisions are made on the side or back of the leg.The cone is cut, sometimes artificial fractures of the main phalanx or the 1st metatarsal bone are created, the fragments are fixed with screws.
In the initial stage of Hallux ValgusThe operation lasts 30-40 minutes, with severe deformation -up to an hour and a half.
Rehabilitation after removal of Hallux Valgus
After one-time removal, recovery lasts about 2 months.The key to a full recovery is to strictly follow the orthopedist's recommendations.If the rehabilitation rules are not taken into account, complications 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
It is allowed to walk in Baruch shoes from the second day.You should before the swelling goes downmove as little as possible, most often lies with the patient's leg.After 2 weeks, walking restrictions are lifted.The use of the Baruk opening remains mandatory for 1-1.5 months after the bone is closed.Then you can wear loose shoes or boots with wide toes.
You should give up heels for six months.
Is it possible to massage after surgery?
After the wound is completely healed, it can be massaged.To improve blood circulation and lymphatic drainage, massage the entire lower part of the limb.The procedure begins with a stroke.Then knead the sole and back of the foot in a circular motion.Hold the ankle joint with your hands and move towards the knee.At the final stage, the blows are carried out again.
Therapy therapy for feet with screws
Physical therapy is a mandatory part of the rehabilitation period for Hallux Valgus and begins in the third week after surgery.First, the finger is bent and extended 3 times, each position lasting 10 seconds.Exercises are repeated 3-4 times a day.All movements are done carefully, avoiding discomfort.
From the second month, after the removal of Hallux Valgus, the number of repetitions increased to 7-8, the number of approaches increased to 6-8 per day.Anxiety 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 and hold this position for about 10 seconds.
It is useful to walk on a slippery surface and climb stairs.
Corrective bandages
After stopping the use of Baruk shoes, a corrective bandage is used.The products consist of two bandages connected by a hinge and fix the thumb in the abduction position.After 1-1.5 months, the bandage is replaced with silicone inserts.The leg should not be squeezed- It interferes with blood circulation and can cause soft tissue injuries.
How to get rid of Hallux Valgus without surgery
In the advanced stages of Hallux Valgus, it is not possible to completely cure the bunion by conservative correction.All conservative methods are used only to relieve pain, prevent complications and development of curvature.
Ensuring resultsTreatment should begin at the first signsAppearance of Hallux Valgus.It is effective along with special exercises, massage, physiotherapy, wearing orthopedic devices, folk remedies.
Foot and big toe massage
It is recommended to be done after a hot bath.
- The leg with the deformed leg, bent at the knee and placed on the thigh of the other leg, entered the sole.
- The sole is kneaded with a fist, pressing on different areas in the distal part.
- Hallux Valgus Lump is massaged in a circular motion, then all fingers are stretched and kneaded.
- To stimulate the release of blood and lymph, bend your arms around your legs and bring your palms to your feet.
Medicines for deformity
Topical anti-inflammatory drugs are used to relieve inflammation in the Hallux Valgus region.
The formation of hallux valgus is accompanied by the development of arthrosis and deterioration of local metabolic processes.Therefore, drugs with chondroselective 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, relieve pain and stimulate tissue regeneration.
To reduce pain and inflammation, compresses with patches, tempolis, burdock and turpentine, red clay and sea salt.All compositions are covered with a bandage, left for 1-2 hours, then washed.
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 Hallux Valgus deformation using massage.Do the following exercises:
- Alternate walking on your heels with support on the outer and inner edges of the foot.
- A casual finish mat.
- Roll an elastic ball.
- Stretching and squeezing the toes while sitting.
- Holding objects (pencils, napkins, small toys).
- Draw different shapes in the air.
- Stretching of the elastic band placed on the big toes, spreading the legs.
- Passive flexion and extension of the affected joint using the hands.
Exercises are completed daily with free stretching and kicking to relieve muscle tension.Only continuous loads can affect the course of the disease.
Orthopedic devices
Taking into account the material, all devices for Hallux Valgus are divided into three groups: soft, semi-hard, hard.Soft ones are used during the day, semi-hard ones - up to several hours.The hard ones are designed to provide foot support at night.
Depending on the type of construction:
- Cross-bar additions- Correct the position of the first finger in the early stages of the deformity or in the postoperative period.Made of soft silicone.
- Single pads- Soft products used to improve shock absorption.Sometimes they are available with a septum that eliminates Hallux Valgus.
- Corrector and bandages- Recommended for moderate and severe stages.They can be soft or semi-rigid and can support a significant portion of the foot.Also used for valgus feet.
- Orthopedic splints- Adjust the hallux valgus angle.In the later stages and only at night, because they are not compatible with shoes.
Physiotherapy for Hallux Valgus
Physiotherapy procedures are considered part of comprehensive treatment and go well with massage and exercise therapy.The following methods are used:
- Paraffin therapy- provides deep warming of muscles and ligaments, improves blood circulation, activates local metabolism.
- Therapeutic mud- It has the same effect as paraffin.Relieves muscle tension.
- Laser therapy- expands capillaries, reduces swelling and improves protein absorption by cells.
- Ultrasound therapy- It activates metabolism and microcirculation in the skin.Stimulates collagen production.Reduces pain and swelling in Hallux Valgus area.
- Shock wave therapy- eliminates stagnant processes, stimulates blood flow, improves the delivery of oxygen and nutrients, and carries out restoration work.It acts effectively not only on ligaments and muscles, but also on osteochondral tissues.
Prevention of Hallux Valgus
Hallux Valgus prevention should start early.Special attention should be paid to the health of children's feet, has a family member who suffers from Hallux Valgus with bunions in the big toes.In the case of transverse flatfoot, a bunion occurs, so children and adults with this pathology should regularly do exercises to strengthen the ligamentum-musculus apparatus.
It is important to choose the right shoes - loose, with stable, stable soles made of natural materials.You have to give up the heel.Wearing an arch support is beneficial.If indicated, the use of orthopedic casts is recommended.Regular, but not excessive, physical activity is beneficial.
To reduce static load, you need to get rid of excess weight.