3/4 Hallux valgus under the microscope: what causes it and how to keep your feet healthy?

3/4 Hallux valgus under the microscope: what causes it and how to keep your feet healthy? 3/4 Hallux valgus under the microscope: what causes it and how to keep your feet healthy?

Walking, Movement and Health

Discover the main causes of hallux valgus and effective ways to prevent it. The right footwear, exercises and care can help keep your feet healthy and pain-free.

Hallux valgus (commonly known as a bunion) isn’t just a cosmetic issue – it’s primarily a health problem that can seriously affect your quality of life. Pain, reduced mobility and difficulty walking are just some of the complications hallux valgus can cause. 

So how does this deformity develop, what influences it, and most importantly – how can you prevent it?

Why prevention and early care matter with bunions

Hallux valgus shows up as the big toe drifting towards the other toes, while the joint at its base becomes enlarged and misshapen. Over time, this shift increases pressure on the neighbouring toes, causes rubbing and can lead to further foot deformities. 

  • It’s not just about the big toe drifting – this diagnosis is often linked to a collapsed transverse arch and overloading of the toe extensor muscles, which can lead to hammer toes or claw toes. The big toe drifting inwards doesn’t necessarily have to be the original cause of the problem.

Hallux valgus is a deformity in which the big toe gradually shifts towards the other toes. At the same time, the joint at its base enlarges and becomes deformed. This shift increases pressure on the surrounding toes, which can lead to rubbing and further deformities of the foot.

However, the issue isn’t only the big toe itself. Hallux valgus often also relates to a collapsed transverse arch and overloading of the muscles that extend the toes. These changes can contribute to hammer toes or claw toes. The drifting big toe isn’t always the main cause of the difficulties – it may be more of a consequence of broader changes in the structure of the foot.

The sooner you start looking after your feet, the better your chances of preventing this problem from progressing. Prevention mainly comes down to choosing the right footwear, doing suitable exercises and having regular check-ups with a specialist.

Hallux valgus: myths vs reality

A common misconception is that bunions are caused only by wearing unsuitable shoes, such as narrow high heels. 

In reality, hallux valgus doesn’t develop overnight. It’s the result of a combination of genetic predisposition, the way you walk, and external factors such as unsuitable footwear. 

Understanding these causes is key both for prevention and for slowing its progression.

Genetic factors

Many people have a genetic predisposition to bunions. If your parents or grandparents had this deformity, it’s more likely to appear in you too.

  • Inherited predispositions – These include the shape and size of the bones, the inclination of the joint surfaces, and the quality of ligaments and connective tissue.
  • A wide intermetatarsal angle – This anatomical feature means a greater distance between the first and second metatarsal bones, which can encourage the big toe to drift.
  • Joint hypermobility – If your joints are overly mobile, the big toe may drift more easily.

The way you walk is crucial

Your gait dynamics play a crucial role in proper weight distribution and stability when walking. If they’re disrupted, it can lead to overloading certain parts of the foot and the gradual development of deformities, including hallux valgus.

  • Morton’s toe – People with a shortened first metatarsal bone place more load on the second metatarsal, which contributes to instability and a higher likelihood of developing hallux valgus.
  • Poor weight distribution when walking – If pressure is distributed unevenly across the foot as you walk, tension around the big toe can increase, leading to gradual deformity. 
  • Foot position while walking also matters – When the hips rotate inwards, the toes often turn outwards. Then, push-off doesn’t go straight through the toes, but through the outer edge of the big toe, where rubbing often develops.

The impact of unsuitable footwear

One of the main factors that worsens hallux valgus is poorly chosen footwear. The most harmful are:

  • High heels – They push the foot into an unnatural position and overload the forefoot.
  • Narrow toe boxes – They squeeze the toes and encourage deformity.
  • Stiff soles – They limit the foot’s natural movement.

Socks can also have a negative effect on bunions – if they pull the toes too tightly together and restrict their movement.

Preventing bunions: what can you do today?

  1. Strengthen your feet with exercises

Regular exercise is one of the key elements of both prevention and management of hallux valgus. Strengthening the foot muscles and stretching the toes helps keep the foot in a natural position and reduce the progression of the deformity. 

Some of the most effective exercises include toe spreading, rolling your foot over a ball, or using your hands to guide the big toe back into better alignment. Exercise not only helps ease pain and stiffness, but also improves overall foot stability and supports healthier movement patterns.

  1. Wear the right shoes

The foundation of preventing bunions – and stopping an existing deformity from getting worse – is wearing shoes that respect the natural shape of your foot. What should ideal footwear offer, and what criteria should you use to choose it?

  • A sufficiently wide toe box – Gives your toes enough space and respects the anatomical shape of the foot. Paradoxically, in the final stage of bunions a narrower toe box may fit the shape better, so adapt the shoe shape to the degree of deformity. 
  • No heel and no drop – Helps keep the foot in a natural position and doesn’t shift your centre of gravity when walking.
  • A flexible sole – In most cases, for people with bunions it supports healthier walking and helps strengthen the foot muscles. However, sometimes the affected joint is either too loose (hypermobility) or, conversely, stiff. In both cases, a flexible sole can cause overload and worsen the problem.
  • Soft materials – They don’t press on the sensitive, misaligned big toe joint.

  1. Walk barefoot and build foot resilience

Walking barefoot strengthens the foot muscles and supports natural weight distribution, which may help ease hallux valgus symptoms and slow further progression of the deformity.

  • Walking on uneven ground – Strengthens muscles and improves proprioception, i.e. the body’s ability to sense its position, movement and force without visual control.
  • Building foot resilience – Helps improve sensitivity and stability in the feet. 

🔎 Bunions and barefoot shoes: when and why is it beneficial to walk ‘barefoot’?

  1. See a specialist

A preventive check-up with a podiatrist, orthopaedic specialist or physiotherapist can help identify predispositions to hallux valgus before serious problems appear.

  • Assessing predispositions – Analysis of foot shape and walking pattern. 
  • Recommendations for suitable footwear – Based on foot shape and the degree of deformity.
  • Custom insoles – For appropriate support and to reduce load.
  • Recommendations for suitable exercises and corrective aids – To support healthy foot function.

NaBOSo works long-term with physiotherapists and other specialists from across the Czech Republic, who will be happy to help you with prevention and solutions for (not only) foot-related issues.

  1. Use corrective aids

If you’re starting to notice the first signs of hallux valgus, various corrective aids may help:

  • Alignment socks and SPLAY Correctors – They gently separate the toes and support their return to a natural, correct position. With regular use, they strengthen the small muscles of the feet, improving stability, walking and overall posture, and may also ease discomfort associated with bunions.
  • Custom orthopaedic insoles – Optimise pressure distribution when walking.

Give your feet the attention they deserve

Even though genetics play a role, how you care for your feet also makes a big difference. The right footwear, regular exercise and early diagnosis can significantly slow the progression of bunions – or even prevent them altogether. 

Don’t ignore the signals your feet are giving you – they deserve the same attention as any other part of your body. Give your feet freedom, space and support, so they can carry you through life without limitations.

This article was created in collaboration with Bc. Edita Prošková – a podiatrist specialising in acquired and congenital foot conditions in children and adults. Through exercises and podiatry aids, she helps restore impaired foot function, which can affect the condition of the entire musculoskeletal system.

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