Hallux valgus is a common orthopedic pathology.It is usually treated surgically.Conservative methods - exercise therapy, massage, physiotherapy, medications - play an important role in the prevention and rehabilitation after Hallux valgus surgery.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 sideways and a bone appears in the area of the metatarsophalangeal joint.The pathology code for hallux valgus according to ICD 10 is M20.1.
The main reasonHallux valgus disease is consideredhereditary 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 diseases.
Degrees of Hallux Valgus and their symptoms
There are several classifications of hallux valgus, which distinguish 3 or 4 degrees of pathology.The authors of the guidelines for orthopedists use the following systematization of the stages of hallux valgus:
| diploma | Deformation angle, in degrees | Deformation signs |
| 1 (weak) | Less than 20 | Painless pile.Sometimes discomfort appears after a long walk. |
| 2 (average) | 25-35 | Severe curvature, difficulty walking in shoes with heels and narrow toes.Possible pain, corns and recurring inflammation of the joint. |
| 3 (severe) | More than 35 | Severe deformity, problems with choosing shoes, difficulty standing and walking, changes in gait.Frequent pains, calluses, corns and accompanying changes in the feet are typical. |
Treatment of hallux valgus deformity of the first toe
The only way to correct severe hallux valgus is surgical correction.Conservative techniques are mainly used 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 taken in two projections with charge.In addition, the doctor may prescribe planography, CT, MRI and other studies.
Hallux valgus correction surgery
Surgical treatment is indicated for moderate to severe hallux valgus deformity.At the patient's request, a minor operation is sometimes performed to eliminate a cosmetic defect.There are many ways 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 (using small punctures).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 first 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
Recovery after lump removal takes about 2 months.The key to a full recovery is strict adherence to the orthopedist's recommendations.If the rules of rehabilitation are not taken into account, complications may develop in the long-term period after the operation - hallux valgus reformation or limitation of movements in the joint throughout life.
What shoes to wear after surgery
From day two you are allowed to walk in Baruch's shoes.Before the swelling goes down, it shouldmove as little as possible, in most cases the patient lies with the leg raised.After 2 weeks, walking restrictions are lifted.The use of a Baruk boot remains mandatory for 1-1.5 months after bone removal.Then you can wear loose sneakers or wide-toed boots.
You must give up heels for six months.
Is it possible to have a massage after surgery?
Massage can be done after the wound has completely healed.To improve blood circulation and lymphatic drainage, massage the entire lower part of the limbs.The procedure begins with a blow.Then cook the sole and back of the leg in a circular motion.Grasp the ankle joint with your hands and move towards the knee.In the final stage, the strokes are performed again.
Exercise therapy for screw feet
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, held in each position for 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 increases to 7-8, the number of approaches - to 6-8 per day.Dissatisfaction is acceptable.Active movements are complemented by passive ones (using the hands).After a month and a half, you should stand up 5-6 times a day, 7-8 times and hold this position for about 10 seconds.
It is useful to walk on an inclined surface and climb stairs.
Corrective bandage
Corrective dressings are used after discontinuing the use of Baruk shoes.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 a silicone insert.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 the advanced stages of hallux valgus, it is impossible to completely cure the ring through conservative correction.All conservative methods are used only to eliminate pain, to prevent complications and progression of curvature.
To ensure resultstreatment should be started at the first signsthe appearance of hallux valgus.Special exercises, massage, physiotherapy, wearing orthopedic equipment 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 turned inwards.
- The nail is cooked with a punch, alternately pressing different areas in the distal part.
- The Hallux valgus bundle is massaged with circular movements, then all the fingers are stretched and kneaded.
- To stimulate the flow of blood and lymph, wrap your arms around the leg and move the palms from the leg to the knee.
Medicines for deformity
To eliminate inflammation in the hallux valgus area, topical anti-inflammatory drugs are used.
The formation of a hallux valgus is associated with the development of arthrosis and the deterioration of local metabolic processes.Therefore, to improve blood flow and stimulate tissue repair, medications 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, eliminate pain and stimulate tissue regeneration.
To reduce pain and inflammation, you can use patches, compresses with propolis, burdock and turpentine, red clay and sea salt.All compounds are applied to the protruding bone, covered with a bandage, left for 1-2 hours, then washed.
Can hallux valgus be corrected with exercise?
Hallux valgus exercises can strengthen ligaments and muscles and have a positive effect on small bones.Therapeutic gymnastics is performed after warming up the hallux valgus deformity using massage.Do the following exercises:
- Alternately walk on the heels with support on the outer and inner edges of the foot.
- Walking on a suspendisse mat.
- Rolling an elastic ball.
- Extension and compression 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 legs.
- Passive flexion and extension of the affected joint using the hands.
Exercises are performed daily, complete with free stretches and kicks to relieve muscle tension.Only constant loads can affect the course of the disease.
Orthopedic equipment
Considering the material, all devices for Hallux valgus are divided into three groups: soft, semi-rigid, hard.Soft ones are used during the day, semi-hard ones - up to several hours.The solid ones are designed to secure the foot during the night.
Depending on the type of construction, there are:
- Insertion between the fingers— correct the position of the first finger in the early stages of the deformity or in the postoperative period.Made of soft silicone.
- Foot pads- soft products used to improve shock absorption.Sometimes they are available with a septum that eliminates hallux valgus.
- Correctors and bandages— Recommended for moderate and severe stages.They can be soft or semi-rigid and support a significant portion of the foot.They are also used for valgus feet.
- Orthopedic tape— adjust the hallux valgus angle.It is used in later stages and only at night, as they are incompatible with shoes.
Physiotherapy for Hallux valgus
Physiotherapy procedures are considered part of a 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- 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— eliminates stagnant processes, stimulates blood flow, improves the distribution of oxygen and nutrients and activates regeneration.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, whose family has relatives suffering from hallux valgus with lumps 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 ligamento-musculus apparatus.
It is important to choose the right shoes - loose, with durable soles, made of natural materials.You have to give up the heels.It is helpful to wear arch supports.If indicated, 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.