Hallux valgus, also known as a bunion, is a common foot condition. Discover the causes, symptoms and effective treatment methods, including how barefoot shoes can help with prevention and recovery.
A Hallux Valgus or bunion occurs in approximately 30% of the adult population in the Western world. Although the severity varies, the impact is often significant: a painful bump, difficulty finding shoes, and decreased stability.
In this article, we dive into the causes (is it really just genetics?) and explain what you can do yourself to address the misalignment.
A Hallux Valgus is a progressive foot deformity where the big toe leans toward the other toes. This pushes the joint at the base of the toe outward, causing a painful, often inflamed bunion. A hallux valgus can lead to pain when walking, difficulty finding suitable shoes, and foot instability.
The condition is more common in women than in men, and the likelihood of symptoms increases as we age.
One culprit is often blamed, but it is usually a combination of factors:
"My mother (or grandmother) had it too," is a common remark. Although scientific research suggests that Hallux Valgus is hereditary (1), no specific Hallux Valgus gene has been found yet. However, you often inherit ligament laxity or hypermobility, which makes the foot more susceptible to deformation.
Ill-fitting shoes and/or high heels are often major culprits. We deliberately do not use the term "narrow shoes." It is more about the shape of the shoe than the actual width.
The problem with classic shoes: In 90% of shoes, the longest point of the shoe is in the middle. However, our feet are longest at the big toe. As a result, the big toe is constantly pushed inward.
The solution: A barefoot shoe has an anatomical shape. This means the shoe follows the shape of a healthy foot. Your toes get the space to spread, which provides more stability and less pressure on the joint.
A flat foot or an abnormal arch can increase pressure on the big toe. Inflammatory conditions such as rheumatoid arthritis can also contribute to the development of Hallux Valgus.
Research on the island of Saint Helena (1965) showed that in a community that largely walked barefoot, only 2% had Hallux Valgus. In the group that did wear shoes, this rose to a staggering 48% among women (2). Research on medieval skeletons also shows that the deformity only exploded when fashionable, pointed footwear was introduced (3, 4).
Conclusion: You may have a predisposition, but your choice of footwear often determines whether the problem actually develops.
We also observe that shoe shape is usually considered a minor cause in the development of Hallux Valgus, while genetics is often seen as the main cause. However, is something being overlooked?
Scientific studies (6, 7) show that non-operative treatment often yields similar results to surgery, but with fewer complications and lower costs:
As long as you wear classic shoes (and keep squeezing your toes), all subsequent steps are essentially pointless! Barefoot shoes (minimalist shoes) are essential for recovery:
Wide toe box: your toes can spread naturally, reducing pressure on the big toe and your painful bunion.
Zero-drop (no heel): your foot stays in a natural, neutral position.
Thin sole: stimulates foot muscles and blood circulation.
By wearing barefoot shoes, your feet get the chance to return to their natural shape and function. Discover how to determine the correct size for barefoot shoes.
Toe spreaders help the big toe return to its natural position. They reduce pressure on the bunion and improve the alignment of the entire foot. Start with short periods and build up gradually.
Strong foot muscles can stabilize the misalignment and even improve it. Some simple exercises for home:
Toe spreading: try to consciously push your toes apart.
The marble exercise: pick up small objects with your toes.
Foot gymnastics: roll the sole of your foot over a tennis or massage ball.
Toe lifts: lift only your big toe while keeping the other toes on the ground.
Want a professional and complete schedule? The specialists at Voetentraining have developed specific programs:
Hallux Valgus Exercise Program via Voetentraining →
A Hallux Valgus is unpleasant, but you are not powerless. Through the combination of wide barefoot shoes, toe spreaders, and targeted exercise therapy, you give your feet the chance to recover.
In case of extreme pain or doubt, it is always wise to consult a podiatrist or orthopedic surgeon.
Fancy shoes and painful feet: Hallux valgus and fracture risk in medieval Cambridge, England
Hallux valgus - a case for a physiotherapist or only for a surgeon? Literature review
Hoewel barefoot schoenen een bestaande botvergroeiing niet operatief kunnen terugdraaien, kunnen ze de verdere progressie van een Hallux Valgus stoppen en de pijn aanzienlijk verlichten. Barefoot schoenen geven je tenen meer ruimte en als je dit combineert met specifieke oefeningen en eventueel teenspreiders, kan de stand van de grote teen zeker en vast verbeteren.
Veel mensen ervaren direct verlichting van de acute drukpijn zodra ze overstappen naar barefoot schoenen met een brede teenbox (toe box). Dit doordat er geen druk meer is op de grote teen. Voor structurele verbetering in de beweeglijkheid van de teen en versterking van de voetboog is vaak een transitieperiode van enkele maanden nodig, waarbij oefeningen cruciaal zijn zodat de voetspieren geleidelijk versterken.
De meeste conventionele schoenen lopen taps toe in de punt, waardoor de grote teen naar binnen wordt gedrukt. In combinatie met een verhoogde hiel (die de druk op de voorvoet vergroot), ontstaat er een constante belasting die het gewricht van de grote teen uit de kom dwingt. Barefoot schoenen elimineren beide problemen door een anatomische vorm en een platte zool. Dankzij de anatomische vorm is er geen druk op je grote teen en wordt deze niet naar binnen geduwd.
Het gebruik van teenspreiders (zoals Correct Toes) kan het herstelproces bij een Hallux Valgus versnellen. Ze helpen de tenen passief in hun natuurlijke stand terug te brengen terwijl je beweegt. Het grote voordeel van barefoot schoenen is dat ze de nodige binnenruimte bieden om deze spreiders comfortabel te kunnen dragen tijdens het wandelen.
Niet alle barefoot of minimalistische schoenen zijn gelijk. Sommige merken zijn over het algemeen smaller of breder. Maar uiteindelijk is het de specifieke pasvorm per model die bepaalt of de schoen voor jouw voet past of niet. Het is dus niet omdat model A van een bepaald merk niet past, dat model B persé ook niet zal passen. Het gaat niet enkel en alleen over hoe breed de schoen is, maar wel op exact welke plek deze schoen breed is en hoe de pasvorm is. Dit kan je helaas enkel weten door verschillende barefoot modellen te passen.
