The worst totally preventable injury

When I'm working, I see this almost everyday.

More than 1 in 3 older adults suffer from this.

The worst part? Even after surgery, it often returns.

Let’s talk about a simple tool that could help avoid the knife altogether.

I'm talking about Hallux Valgus.

Hallux valgus is a common foot deformity that unfortunately affects more than one-third of elderly people and can be a real struggle for runners.

The unnatural alignment of the big toe interferes with a strong toe off and causes compensation further up the kinetic chain. It leads to over pronation and can also lead to excessive rotation in the hips.

Beyond the mobility issues it causes, hallux valgus also places a significant burden on public healthcare due to the high demand for foot surgeries.

However, even after surgery, there is a high recurrence of the same deformity.

So if surgery isn’t the solution, what is?

Hallux valgus is a misalignment of the foot, often caused by wearing narrow shoes for a great part of your life. To fix this, the foot needs to be realigned.

The best way to achieve this is with toe spacers. Toe spacers help reposition the bones of the foot and activate previously inactive muscles, allowing the foot to support itself again over time.

A 2021 meta-analysis found that:

• “The treatment effect of orthoses with a toe separator on hallux valgus angle (HVA) correction is larger than that of dynamic orthoses.”

• “The use of orthoses with a toe separator for moderate-degree patients with HV can reduce HVA and hallux pain without serious complications.”

Initially, toe spacers may feel uncomfortable because your foot has adapted to an unnatural position. They will stretch tight muscles and activate others that have been inactive for a long time.

Remember: Take it slow.

Start by wearing them for just five minutes around the house and gradually increase the duration, just as you would with any other exercise. This is not a quick fix. This is a long term approach to improve your foot health for the better. This is exercise for your feet!

Additionally, for even better results, consider switching to toe socks and foot-shaped shoes. This stops your sock & shoe from sqeezing your toes together and will allow you to wear toe spacers for longer periods. While barefoot shoes have been shown to increase foot muscle activity, they don’t directly reduce HVA on their own.

Toe spacers can also be beneficial for tailor’s bunion, a similar deformity affecting the small toe.

As runners we have to take great care of our feet. Doing so with toe socks and toe spacers is the lowest hanging fruit.

I strongly believe in this simple approach to foot health; wear wide toebox shoes with toe socks in daily life and wear whatever you like while running.

The 6-12 hours you run don't cause permanent damage, the 70+ hours of wearing regular shoes do.

Thank you for reading 👟

- Tim

P.S. Struggling with hallux valgus and unsure which running shoe is right for you? I offer personalized shoe consultations where we’ll assess your gait, goals, and symptoms and find the shoe that truly fits your needs.