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Hallux Abducto Valgus (Bunions)

A bunion (hallux abducto valgus) is a valgus deviation of the hallux, commonly associated with an exostosis on the 1st metatarso-phalangeal joint.


When irritated by tight or ill-fitting shoes, bunions can become red and swollen.

Biomechanical etiology

Bunions are most commonly caused by forefoot adductus and excess pronation of the subtalar joint. Some bunions are caused by arthritis or trauma.

Due to excessive pronation, forces load the medial forefoot area. This increased adductory load on the 1st metatarsal shaft causes rotation of the shaft, which then requires the hallux (big toe) to compensate by abducting. Feet that have short 1st metatarsals or hypermobility are more susceptible to this condition.


Orthotics control excess pronation (although not forefoot adductus), which reduces load on the medial forefoot area and valgus deviation of the hallux. Sometimes surgery may be indicated. Postoperative orthotic treatment should always be considered.


  • Intrinsic forefoot exercises