Hallux Valgus Deformity (aka Bunions)

Author: Jerry Song

Hallux valgus is a structural deformity of the foot that involves the angling of the great toe (hallux) towards the second toe, accompanied by a bony prominence known as a bunion on the medial aspect of the first metatarsophalangeal joint (MTPJ). This deformity can lead to pain, discomfort, and functional limitations, significantly affecting an individual’s quality of life. While surgical intervention is often considered for severe cases, conservative treatments, including manual therapy, play a vital role in managing symptoms and slowing the progression of the deformity.

Hallux valgus develops due to a combination of intrinsic and extrinsic factors:

1. Genetic Predisposition: Family history of hallux valgus suggests a genetic component that affects foot biomechanics and structural alignment.
2. Footwear: Wearing narrow, high-heeled, or poorly fitting shoes can exacerbate or contribute to the development of hallux valgus by applying abnormal pressure on the toes and altering foot mechanics.
3. Biomechanical Factors: Abnormal foot mechanics, such as overpronation or excessive supination, can contribute to the development of hallux valgus. Muscle imbalances and weak intrinsic foot muscles may also play a role.
4. Arthritis: Conditions like rheumatoid arthritis can affect joint alignment and contribute to the development of hallux valgus.
5. Trauma: Previous injuries to the foot or toe can impact the alignment of the great toe and contribute to the deformity.
6. Muscle Imbalance: Weakness or imbalance in the muscles supporting the foot can affect the alignment of the toe and exacerbate the deformity.

Hallux valgus develops due to a combination of intrinsic and extrinsic factors:

1. Age: The condition is more common in older adults, with the prevalence increasing with age due to cumulative biomechanical stress and degenerative changes.
2. Gender: Women are significantly more likely to develop hallux valgus than men. This disparity is often attributed to footwear choices, such as high heels and narrow-toed shoes, which can exacerbate the deformity.
3. Family History: Individuals with a family history of hallux valgus are at a higher risk, indicating a genetic predisposition.
4. Footwear Choices: Wearing tight, narrow, or high-heeled shoes regularly increases the likelihood of developing hallux valgus, especially in women.

Manual therapy can play a supportive role in managing hallux valgus by alleviating symptoms, improving foot function, and addressing contributing factors. Key manual therapy interventions include:

1. Dry Needling

Dry needling involves the insertion of fine needles into specific trigger points or areas of muscle tightness to promote pain relief and muscle relaxation. Benefits of dry needling for hallux valgus include:

• Reduction of Muscle Tightness: Targeting trigger points in the foot and lower leg muscles, such as the flexors and extensors, can alleviate tightness and improve muscle balance.
• Pain Relief: By disrupting pain signals and promoting local blood flow, dry needling can effectively reduce foot pain and discomfort associated with hallux valgus.
• Improved Muscle Function: Enhancing muscle function around the foot can aid in improving foot mechanics and reducing abnormal stress on the MTPJ.

2. Myofascial Cupping

Myofascial cupping involves using suction cups to create negative pressure on the skin, lifting and separating the underlying tissues. This technique can:

• Enhance Blood Circulation: Improved blood flow helps in nutrient delivery and waste removal, promoting tissue healing and reducing inflammation in the affected area.
• Release Myofascial Restrictions: Loosening tight fascia and muscle adhesions can restore normal tissue mobility and alleviate pain associated with hallux valgus.
• Reduce Muscle Spasms: The negative pressure can help relax muscle spasms, improving muscle tone and function in the foot.

3. Soft Tissue Mobilisation

Soft tissue mobilisation techniques include massage and myofascial release to manipulate the soft tissues around the foot and toe:

• Massage Therapy: Techniques like deep tissue massage can reduce muscle tension, improve circulation, and decrease pain, facilitating recovery and improving foot function.
• Myofascial Release: Applying sustained pressure to myofascial restrictions can eliminate pain and restore motion, addressing tightness in the foot and lower leg muscles.

4. Joint Mobilisation

Joint mobilisation involves applying controlled forces to the MTPJ and surrounding joints to improve range of motion and alleviate pain:

• MTPJ Mobilisation: Techniques to mobilise the MTPJ can enhance joint mobility, reduce stiffness, and correct abnormal mechanics contributing to hallux valgus.
• Manual Traction: Applying gentle traction to the MTPJ can reduce joint compression, alleviate pain, and improve alignment.

5. Manual Stretching

Manual stretching techniques aim to improve flexibility and reduce tension in the muscles and tissues around the foot:

• Toe and Foot Stretching: Stretching the intrinsic and extrinsic muscles of the foot can relieve tension and improve flexibility, aiding in better alignment and function.
• Calf Stretching: Addressing tightness in the calf muscles can improve overall foot mechanics and reduce stress on the MTPJ.

6. Proprioceptive Neuromuscular Facilitation (PNF)

PNF stretching combines stretching and contracting targeted muscle groups to enhance flexibility and strength:

• PNF Techniques: Effective for improving the flexibility and strength of the foot muscles, promoting better mechanics and reducing pain associated with hallux valgus.

If you or someone you know are dealing with bunions, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see Jerry now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain. Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.