Hallux valgus is a common foot deformity characterized by lateral deviation of the great toe and medial prominence of the first metatarsal head. It often leads to pain, functional limitations, and reduced quality of life, particularly in elderly individuals. Physiotherapy plays a crucial role in the conservative management of hallux valgus, aiming to alleviate pain, improve joint mobility, and optimize foot biomechanics. Taping techniques can provide immediate symptomatic relief and support, complementing the overall treatment approach.
Case Presentation
A 74-year-old female presented with a chief complaint of persistent pain and difficulty walking due to bilateral hallux valgus deformity. She reported experiencing discomfort, particularly during weight-bearing activities and prolonged standing. Physical examination at our Etobicoke Physiotherapy clinic revealed lateral deviation of both great toes, accompanied by inflammation and tenderness over the medial eminence of the first metatarsophalangeal joints (MTPJs). The patient demonstrated restricted range of motion and weakness in the intrinsic foot muscles.
Management
The management plan consisted of a comprehensive physiotherapy program supplemented by taping techniques. The goals were to reduce pain, improve joint mobility, strengthen foot musculature, and enhance functional capacity. The treatment protocol included the following components:
- Manual Therapy: Soft tissue mobilization techniques, such as massage and myofascial release, were utilized to alleviate muscle tightness and improve tissue extensibility around the affected MTPJs.
- Strengthening Exercises: Emphasis was placed on exercises targeting the intrinsic and extrinsic foot muscles to enhance dynamic stability and support the longitudinal arch. This included toe curls, marble pickups, and towel scrunches.
- Joint Mobilization: Gentle joint mobilization techniques were applied to improve the range of motion of the MTPJs and restore normal joint mechanics.
- Gait Training: The patient underwent gait analysis to identify aberrant movement patterns and received guidance on proper foot mechanics during walking to minimize stress on the affected structures.
- Patient Education: The patient was educated about the etiology of hallux valgus, factors contributing to symptom exacerbation, and self-management strategies, including footwear modification and activity modification.
Taping Technique
Taping was employed as an adjunctive intervention to provide immediate pain relief and biomechanical support. The following taping technique was utilized:
Toe Alignment: Kinesiology tape was used to gently realign the great toe, reducing the angle of deviation and minimizing friction over the medial eminence. The tape was applied in a corrective manner, pulling the toe towards its anatomical position while allowing for pain-free movement.
Outcome
The patient responded favorably to the physiotherapy intervention and taping techniques. Over the course of treatment, she reported a significant reduction in pain intensity, improved joint mobility, and enhanced functional mobility. She demonstrated increased confidence during weight-bearing activities and reported a higher level of satisfaction with her overall foot function.
Follow-up assessments indicated sustained improvements, highlighting the effectiveness of the conservative management approach.
Physiotherapy, supplemented by taping techniques, can effectively manage hallux valgus deformity in elderly patients, providing symptomatic relief, improving foot biomechanics, and enhancing functional capacity. A multidisciplinary approach, including patient education and self-management strategies, is essential for optimizing long-term outcomes and promoting patient satisfaction.
