“Hallux valgus is a common deformity of the big toe. It is a deformity which occurs in around 2%-4% of the population of the Western world, and leads to over half a million surgical procedures annually, to repair it. The deformity includes the big toe deviating towards the other toes, which causes a bone to protrude on the inner side of the sole of the foot, at the big toe joint. The protruding bone rubs against the sides of the shoe and creates an ongoing infection in that place, which causes recognizable discomfort and pain,” explains Dr. Uri Hadash, a senior physician in the Orthopedics B Department at the Hillel Yaffe Medical Center.
Dr. Hadash also notes that specific people have a tendency to develop the hallux valgus deformity, whether the cause is genetic, the person’s anatomic structure and the flexibility of the ligaments of the foot, or whether it happens in the wake of neuromuscular disorders, or problems such as flat feet, neurological disorders, etc. An additional dimension is added to all of these, in the type of shoes, particularly high heels, which play a significant role in the deformity. In addition, wearing high heels leads the ankle joint to being less stable, and thereby causes repeated sprains and a lack of ankle stability. The way weight is borne by the foot when wearing high heels is not the usual, natural way, since most of the bodyweight is carried by the toe joints and there is clear pressure on the forefoot, which creates problems and deformities in the toes and hallux valgus. The fact that most high heeled shoes have a narrow toebox creates even more deformities and increases the pain.
In Europe, for example, especially in countries such as France or Italy, where women “never get off their heels,” surgery for such deformities is mainly performed on young women, as opposed to the average age in the world which is 60. Despite this, almost all of them return to wearing heels, even at the price of repeated surgery.
Avoid walking with high heels. Dr. Uri Hadash
Treatment and prevention
“During the early stages of the problem, conservative treatment can be used by immobilizing the foot in special devices which straighten the big toe inside the shoe, walking with custom-made orthotics, and creating a separation between the big toe and the other toes. At more advanced stages, the deformity can be treated surgically,” explains Dr. Hadash.
Surgery generally includes removing bone protrusion and part of the metatarsal heads, and later repositioning the big toe in the direction of the other toes, while straightening it. At the Hillel Yaffe Medical Center, we use additional methods, using an incision only 1-2 cms long, thus enabling the smallest possible harm to the area.
In summary, to prevent foot deformities, Dr. Hadash recommends wearing flat shoes that are wide enough to enclose the toes without crushing them, and to avoid walking with high heels as much as possible. If you still insist on wearing high heels, prefer those that are broad and stable, rather than pin-thin stiletto heels.