Causes and Risk Factors of Hallux Valgus

Understanding the causes of hallux valgus is the first step in prevention and correction. The formation of hallux valgus is usually the result of multiple factors working together, mainly including the following aspects:

Genetic factors play an important role in the occurrence of hallux valgus. Studies show that about 58%-88% of patients with hallux valgus have a family history. Certain hereditary connective tissue diseases, such as Ehlers-Danlos syndrome or Marfan syndrome, increase the risk of developing hallux valgus, as these diseases lead to ligament laxity, which cannot effectively maintain the normal structure of the foot.

Inappropriate footwear is a major external factor leading to hallux valgus. Long-term wearing of high-heeled shoes, especially those with heels over 5 centimeters and narrow toe boxes, puts excessive pressure on the forefoot, forcing the big toe to deviate outward. Similarly, shoes with overly narrow toe boxes can squeeze the toes, altering the normal line of force in the foot, gradually leading to deformity. Statistics show that women who wear high heels are 9 times more likely to develop hallux valgus than those who do not.

Abnormal foot structure is also an important trigger. Patients with flat feet have a collapsed arch, which causes excessive pronation of the foot while walking, increasing the risk of hallux valgus. Additionally, anatomical variations such as a long or short first metatarsal and hypermobility of the joints can disrupt the mechanical balance of the foot, leading to hallux valgus.

Age and gender are also significant influencing factors. The incidence of hallux valgus increases with age, which is related to ligament laxity and decreased muscle strength. Women have a significantly higher prevalence than men due to hormonal influences (estrogen can increase ligament laxity) and a greater tendency to wear inappropriate shoes, with a male-to-female ratio of about 1:3 to 1:15.

Effective Methods to Prevent Hallux Valgus

Prevention is better than treatment. Taking scientifically reasonable preventive measures against various risk factors for hallux valgus can significantly reduce the risk of developing the condition. Here are some clinically validated effective prevention methods:

Choosing appropriate shoes is the most basic and important preventive measure. Ideal shoes should have the following characteristics: a spacious toe box to provide ample room for toe movement; a heel height not exceeding 3 centimeters to avoid excessive pressure on the forefoot; a sole with good support and moderate elasticity; and soft, breathable materials that do not rub against the skin of the foot. It is recommended to buy shoes in the afternoon or evening when the feet are slightly swollen, allowing for a more accurate assessment of comfort. When trying on shoes, wear socks and ensure there is about a 1-centimeter gap between the longest toe and the toe box. Avoid wearing pointed shoes, high heels, or flip-flops for extended periods, as these styles can alter normal gait and increase the risk of hallux valgus.

Foot muscle exercises can enhance the strength of the intrinsic muscles of the foot, maintain arch stability, and prevent hallux valgus. Simple and effective exercises include: toe towel grabs (placing a towel on the floor and repeatedly grabbing it with the toes); toe separation exercises (attempting to move each toe individually); and arch lifts (contracting the muscles of the foot while sitting or standing to form an arch). Consistently performing 10-15 minutes of foot exercises daily can significantly improve the mechanical balance of the foot over time. Low-impact activities such as swimming and cycling also help strengthen lower limb muscle strength without increasing the burden on the feet.

Using orthotic devices has a good preventive effect for high-risk groups. Custom orthotic insoles can correct abnormal gait and redistribute pressure on the foot, especially suitable for individuals with flat feet or high arches. Silicone toe separators or nighttime corrective braces can maintain the normal position of the toes during sleep, preventing the progression of deformity. It is best to consult a foot and ankle specialist or physical therapist before choosing orthotic devices to ensure they are suitable for individual foot characteristics.

Maintaining a healthy weight is also important for preventing hallux valgus. Being overweight increases the load on the feet and accelerates structural deformation. Controlling weight within a reasonable range through a balanced diet and regular exercise can effectively reduce pressure on the feet. Individuals with a BMI over 25 should pay special attention to foot health and adjust their lifestyle in a timely manner.

Regular foot examinations can help detect tendencies toward hallux valgus early. Pay attention to signs such as: slight protrusion at the base of the big toe, the big toe starting to lean toward the second toe, abnormal calluses on the sole, and localized pain after wearing shoes. Those with a family history should undergo a professional foot assessment annually, including gait analysis and pressure testing.

Avoiding prolonged standing or walking is also important for preventing hallux valgus. Workers who need to stand for long periods should use anti-fatigue mats and change positions regularly. After long walks, elevate the feet to rest and perform foot massages to relax. Athletes should choose specialized footwear suitable for their specific sport and pay attention to gradually increasing training volume.

By comprehensively adopting these preventive measures, even those with a genetic predisposition can significantly delay or avoid the occurrence of hallux valgus. It is particularly emphasized to start paying attention to foot health from adolescence, as the bones of the foot have not yet fully formed and are more susceptible to adverse factors.

Non-Surgical Correction Methods

Physical therapy is a core component of conservative treatment. Professional physical therapists can design personalized rehabilitation programs, including ultrasound therapy, electrical stimulation, ice packs, or heat therapy, which can effectively reduce inflammation and pain. Manual therapy techniques such as joint mobilization and soft tissue relaxation can improve joint mobility in the foot and relieve muscle tension.

The use of orthotic devices plays an important role in non-surgical correction. Silicone toe pads for daytime use can mechanically separate the first and second toes, reducing lateral pressure on the big toe, making them suitable for daily wear. More corrective nighttime splints can apply continuous gentle corrective force during sleep, gradually improving the angle of valgus. Custom orthotic insoles can redistribute pressure on the foot, correct abnormal gait, and reduce impact on the big toe joint while walking.