Pain in the big toe

Hallux valgus

What is that?

Hallux valgus is the outward deviation of the big toe, which creates a visually visible “bump”. 

How does this manifest itself?

The pain usually starts after wearing shoes that are too tight. It radiates into the big toe. The base joint of the big toe is particularly often affected. Over time, a painful bump forms. This is either bony or manifests itself as an elastic bursa that forms as protection against too much pressure. 

Where does it come from? 

The development of hallux valgus can be genetic. But it can also be caused by foot misalignment, weak connective tissue or wearing shoes that are too tight or have high heels. In men, this misalignment can be seen after wearing sports shoes that are too tight, as is often the case with football players. 

If the big toe is permanently pushed out of its joint, this leads to increased wear and tear of the metatarsophalangeal joint. This causes the foot muscles to become unbalanced, which in turn promotes misalignment.

What happens if I don’t act here?

The misalignment of the big toe can lead to arthrosis in the metatarsophalangeal joint, which in turn leads to stiffening of the joint. Unfortunately, the joint loses its function due to both the misalignment and the stiffening. However, this is essential for a physiological gait. The big toe metatarsophalangeal joint is used for rolling and pushing off. If the foot loses this function, it must be compensated for by other joints, for example the metatarsophalangeal joints of the little toes or the outer edge of the foot. In both cases, the adjacent joints, such as the upper and lower ankle joints, are incorrectly loaded, which can lead to further problems. 

Overloading the little toes can lead to inflammation of the metatarsal heads and the development of claw toes, which can make rolling over while walking very painful. 

How do I find out if I have something like this?

The diagnosis is made based on the medical history and the trained eye of a doctor. A grade classification (grades I-IV) can be made, which can be confirmed by an X-ray of the forefoot. The decisive factor in recommending treatment is checking how mobile the metatarsophalangeal joint is up and down, and how much the contracted capsule restricts the joint. 

How do you treat this?

It is important to first treat the foot deformity by providing an optimized insole. The aim here is to achieve a sufficient elevation of the medial longitudinal arch and the straightening of the transverse arch in order to protect and cushion the metatarsophalangeal joint of the big toe.

At the same time, the metatarsophalangeal joint of the big toe and especially the forefoot and midfoot should be mobilized using manual therapy. In order to straighten the arch of the foot in the long term and to learn to walk physiologically again, active mobilization of the foot muscles using Spiraldynamik® is a valuable therapy option. In addition, aids such as hallux tape or taping socks can be used to change the motor patterns.

In addition, the footwear should be optimized. Shoes with thick, soft soles and enough space in the toe area often make things much easier. The shoe market now offers many rock shoe models that can be fitted with insoles, as well as fashionable boots.  

Insoles do not have to be thick or bulky. They should simply correct where necessary and have padding to provide relief. The kokochii® insoles offer compatible solutions for a wide range of shoe models. They are therefore real all-rounders when it comes to relieving pain caused by hallux valgus.
kokochii® insoles are max. 2.5 mm thick. They reliably straighten the longitudinal arch and thus the big toe. Due to their low volume, the insole leaves enough space for the ankles to maintain their natural movement. Individually placed pads and cushions can straighten the transverse arch of the foot and relieve pressure on the metatarsal heads. Another positive effect is that the foot is narrowed.