hallux valgus is a common foot deformity, presenting in 35% of women over 65 years of age. The progression of deformity is seen as an offset in first metatarsophalangeal (MTP) joint alignment, whereby the hallux shifts laterally and the first metatarsal medially. Other alterations may include collapse of the arch and rolling of the hindfoot. If left untreated and allowed to progress to its eventual end stage, the deformity renders the truss mechanics of the foot ineffective and impairs gait
Hallux valgus deformity is typically accompanied by an overgrowth of bone (exostosis) and tissue that develop on the dorsomedial eminence of the first metatarsal head. The enlargement is called bunion.The swollen area may be painful and may aggravate the condition.The growth in combination with the progressive first MTP joint malalignment may further disrupt gait,and, for these reasons, the terms bunion and hallux valgus are often used interchangeably to describe the comorbid nature of the foot disorder Although the exact etiology of hallux valgus is not understood, its prevalence is highest in females with symptoms of deformity exacerbated by fashion shoe wear.Alterations in the alignment of the medial arch may be a modifiable risk factor, as research has identified eversion of the calcaneus and adduction of the first metatarsal as causal factors. This has prompted new ideas for treatment.This clinical commentary describes an exercise approach, premised on slowing the progression of deformity by optimizing the length tension relationship of muscle. Because muscle generates its greatest tension at ideal resting length and less tension when stretched or shortened, deformity reduces the capacity of muscle to produce the force needed to support weight. In building a case for intervention with exercise, this clinical commentary informs a rationale for prevention instead of delaying care until after impairments become severe and surgery is required