Big Toe Problems – Treatment & Management

Everyone knows at least one friend or relation is that is affected by an alignment problem of the Big Toe. In many cases, a painful Bunion forms at the base of the big toe and can be extremely painful when pressure is applied to that area. It occurs due the metatarsal bone of the big toe angling outwards and the big toe itself angling inwards pushing against the second toe. This Angling inwards of the Big Toe is known as Hallux Valgus Deformity. It can lead to ankle joint degeneration, Knee pain, poor balance and Hip problems. The Hallux Valgus deformity are predominately hereditary, but there occurance is greatly enhanced by wearing of shoes with narrow toe boxes, such as high heels. Such narrow fitting shoes force the big toe to be pushed inwards towards the 2nd toe leading to the eventual outward angling of the joint at the base of the big toe.

Hallux Valgus Deformity leads to Bunion formation

Bunion occurs after Hallux Valgus Deformity

Treatment & Management

Even though in many cases the angling inwards of the Big Toe cannot be altered to its original position by conservative treatment, it still needs to be treated to prevent its angle worsening leading to bunions, and poor foot control when walking which can result in knee and ankle problems overtime. The Hallux Valgus of the Big Toe can be managed by physio Taping techniques which achieve some success over a 6-8 week period. In addition, manual release of tight flexor tendons that attach underneath the 1st metatarsal bone and Big Toe can help improve Big Toe Alignment. The importance of transverse arch and toe strengthening exercises is dependent on the level of dysfunction of Big toe inward angling.

What can you do?

A poor fitting shoe accelerates the angling inwards of the Big Toe and the formation of bunions, hence we need to do the following;

  • Avoid wearing high heels with a very narrow heel base

  • If wearing a high heel, pick a shoe with a gradual incline

  • Don’t wear a high heel where there is a big gap behind the heel

  • Wear a silicone metatarsal pad underneath the ball of the foot with high heels.

Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles. Contact Number: 0504 26672

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Physiotherapy & Injury Rehabilitation Clinic in Tipperary

0504 26672


The Surgery, Fianna Road, Thurles


Riverside Medical Centre, 7 Upper

Irishtown, Clonmel

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