28/07/2026
Hallux Valgus
Hallux valgus is not simply a problem of the big toe. It may reflect dysfunction of the foot’s weight-bearing and push-off mechanisms. When compensation travels upward through the kinetic chain, it may affect the ankle, knee, hip, and pelvis, and may even increase mechanical stress on the lower back.
Its local mechanism is mainly associated with an imbalance between a tight adductor hallucis and a weak abductor hallucis.
1. The adductor hallucis continuously pulls the big toe toward the second toe.
2. The abductor hallucis is unable to provide sufficient counterforce, reducing stability of the first metatarsophalangeal joint.
3. The big toe gradually deviates toward the second toe, resulting in hallux valgus.
4. As the deformity progresses, the abductor hallucis shifts toward the plantar aspect of the foot. Its line of pull changes, its mechanical advantage decreases, and its function becomes progressively weaker, creating a vicious cycle.
Therefore, the main goals of local rehabilitation are to release the tight adductor hallucis and to activate and strengthen the abductor hallucis.
The overall causes, however, are much more complex and may differ from one person to another. Common contributing factors include:
* Collapse of the medial longitudinal arch
* Instability of the first metatarsal
* Excessive foot pronation
* Abnormal mobility of the first metatarsophalangeal joint
* Dysfunction of the tibialis posterior, fibularis longus, and intrinsic foot muscles
* Tightness of the calf muscles
* Prolonged use of narrow or constrictive footwear
These factors can alter load distribution across the foot and affect the alignment of the first metatarsal and the big toe. Therefore, rehabilitation for hallux valgus should not focus solely on the local muscle imbalance. It should also include a comprehensive assessment of foot alignment, joint mobility, muscle strength, and gait, followed by an individualized treatment plan.
Hallux valgus is not merely a local deformity. It is often part of a broader dysfunction of the foot’s biomechanical system. Local soft-tissue release and strengthening may improve symptoms, but more stable and lasting results depend on identifying and correcting the underlying biomechanical dysfunctions.
