Hallux Valgus is a condition where the big toe starts to curve inwards, causing an increase to the width of the forefoot and subsequent rubbing on the upper of your shoes. You may also get Metatarsalgia type discomfort from the altered weight bearing area, or strain in the mid foot from poor positioning.
An alteration to the position of the great toe can greatly change the propulsive phase of the gait cycle. If there is a restriction in the muscular action around the great toe joint leading to the change in the biomechanical advantage of the soft tissues and bony anatomy responsible for propulsion. This can lead to compensatory movements in the foot to allow forward motion.
The reasons for the onset of Hallux Valgus are many, including inflammatory arthropathies (Rheumatoid Arthritis, Gouty Arthritis), genetic disposition (Ehlos Danlos Syndrome, Downs Syndrome, Familial), hypermobility and over pronation.
It is not thought that poorly fitting footwear (high heels/narrow toe boxes) are a causative factor. However, it is agreed that the wearing of such footwear is not going to be helpful on the whole by not allowing the movement of the affected toe into its natural position.
Although orthotics can’t return the toe to the original position, they can be used to slow the progression and give relief from the discomfort.
Insoles can also realign the mid and hind foot position to reduce the risk of further progression and/or offload high pressure areas if the foot position cannot be changed.
In the high-risk foot i.e. neuropathy from Diabetes, a Total Contact Insole (TCI) may be required to give targeted pressure relief along with footwear to accommodate the shape of your foot and reduce the risk to higher pressure areas.