From the Guidelines
For hallux valgus, I strongly recommend a combination of stretching and strengthening exercises, as outlined below, to help manage symptoms and potentially slow progression, prioritizing morbidity, mortality, and quality of life as the primary outcomes. When considering exercises for hallux valgus, it's essential to focus on stretches that improve flexibility and strengthen the muscles around the foot and ankle.
- Toe stretches: Gently pull your big toe into proper alignment for 10 seconds, repeating 10 times daily, as this can help improve flexibility and reduce discomfort 1.
- Toe spreading: Actively separate all toes and hold for 5 seconds, doing 10-15 repetitions twice daily, to strengthen intrinsic foot muscles and improve dexterity.
- Towel scrunches: Place a towel on the floor and use your toes to scrunch it toward you for 2-3 sets of 10-15 repetitions, which can help strengthen the muscles that support the foot arch and toes.
- Marble pickups: Lift small objects with your toes to improve dexterity and strength, aiming for 10-15 repetitions twice daily.
- Calf stretches: Stand facing a wall with your affected foot behind you, keeping the heel down while leaning forward until you feel a stretch in your calf, holding for 30 seconds and repeating 3 times, as tight calf muscles can contribute to foot and ankle issues 1. It's also crucial to wear proper footwear with a wide toe box and low heels to complement these exercises and reduce pressure on the affected area, as recommended for managing foot care in patients with diabetes or those at risk of foot ulcers 1. If pain persists or worsens, consulting a podiatrist or physical therapist for personalized guidance is essential to ensure the best possible outcomes in terms of morbidity, mortality, and quality of life.
From the Research
Stretches and Exercises for Hallux Valgus
- There are various conservative treatments for hallux valgus, including exercises and stretches, that can help alleviate symptoms and improve the condition 2, 3.
- A combination of exercise and toe separator, night splints, and dry needling are most likely to be the best choice for reducing the hallux valgus angle (HVA) and intermetatarsal angle 2.
- Toe separators (with or without exercise), dry needling, and manipulation (with or without ice treatment) have advantages in improving the subjective feeling of patients 2.
- Functional stabilization of the foot by means of gymnastics or physiotherapy instructions can help prevent the progression of hallux valgus deformity 3.
- Manual therapies, physiotherapy, orthotics or orthopedic measures can be adopted in view of the existing pathology and suffering pressure 3.
Conservative Treatment Options
- Conservative measures can only be applied to relieve the symptoms of hallux valgus, and cannot improve forefoot deformity 4.
- Orthotic devices can alleviate symptoms due to increased local pressure, and splints can help retain joint congruency and assure proper toe position during soft tissue healing after surgery 4.
- Shoe modification and orthotics can help improve symptoms and bring pain relief, but there is no consensus that conservative management can correct the pathology or terminate the clinical worsening of the condition 5.
- Proper footwear, including shoes with an adequate length, wide toe box, cushioned sole, and a lowered heel, can help reduce the load on the metatarsal heads and cause pain 5.