What is a Hallux Valgus

A Hallux Valgus is a big toe that grows crooked inwards. This is accompanied by a large bump (bunion) at the joint of the big toe. A hallux valgus can cause many complaints:

• Pain at the bunion: because (traditional) shoes continuously push against this bunion, it becomes inflamed and you have pain. The pressure can also cause extra callus formation, blisters,...
• Pain in your other toes: your big toe pushes against your other toes and takes their place. This can then lead to other problems such as hammertoes.
• Balance: Your big toe is actually the "anchor" of your body. The more the position deviates inward, the less balance you will have.
• Difficulty walking due to reduced stability.

What causes a Hallux Valgus?

A Hallux Valgus can have several causes:

• More common in women than in men
• More common in people who have diseases associated with inflammation (such as rheumatoid arthritis)
• Sometimes the cause is another physical problem such as a dropped forefoot or a shortened Achilles tendon .
• The position of your feet can also influence the development of a hallux valgus.
• However, a hugely underestimated and underexposed problem is the shoes that most people wear.

What is striking is that a number of factors such as a collapsed forefoot, shortened Achilles tendon, position of your feet, are also regularly (but not always!) related to classic or conventional shoes.

In addition, we have customers in our store every week who come specifically because they have a hallux valgus. And a large majority say the same thing: "Yes, but I can't do anything about it. With me it is hereditary because my mother, grandmother,... has/had that too." However, this hereditary factor is greatly overestimated and a factor that these family members almost always share is the shoes they wear!

I would like to refer to a study ⁽¹⁾ that was published as early as 1965. On the island of St. Helena, a study was conducted into the presence of Hallux Valgus in islanders who usually walked barefoot, and residents who mainly wore shoes . The length of time the subjects had been wearing shoes was also examined. Given that at that time the average weekly income on St. Helena was less than £3 per week, it was not unusual that 54% of the population surveyed preferred to go barefoot. If shoes were worn, these were mainly shoes with a flat heel and a round toe (for both men and women). In recent years, however, younger women have also been switching to shoes with high heels and pointed toes.

The results of this study? The study showed that there was a deviation of the big toe of more than 15° in:

• 2% of the barefoot population
• 16% of men and 48% of women who had been wearing shoes for a long time .

The longer shoes were worn (in years), the greater the number of subjects with a hallux valgus (>15°). The increase in incidence was linear, could not be attributed to age, social class, occupation or exercise habits. The conclusion was that the increase in hallux valgus was probably a direct effect of wearing shoes.

Influence of shoes on a hallux valgus

The image above makes a lot clear right away. On the right we see a classic shoe shape:

• the shoe is symmetrical
• the top of the shoe is in the middle (and as long as the shoe is symmetrical, it doesn't really matter whether the top is pointed, flat, round, etc.)
• widest point of the shoe does not match the widest point of the foot.

By putting a foot on this shoe shape, we immediately notice that a healthy foot does not actually fit in this shoe. The big toe is continuously pushed inwards and usually the little toe will also grow under or above the second smallest toe because there is not enough space. Combine this with a raised heel and it should not surprise you that this is asking for problems! Moreover, most people wear their shoes too small (scientific research shows that a shoe should actually be 12 mm longer than your foot)

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(1) IB Shine, 1965, Incidence of hallux valgus in partially shoe-wearing community, British Medical Journal, Jun 26;1(5451):1648-1650