Early diagnosis and treatment are keys to returning these active people expeditiously and safely to their sports. This article reviews current concepts in the management of foot problems common in active middle-aged individuals. Hallux Valgus Pathologic changes can lead to angulation of the great toe into valgus, enlargement of the medial portion of the first metatarsal, and thickening over the medial bursa. The causes of hallux valgus include heredity, metatarsus primus varus, pes planus, rheumatoid arthritis, and neurologic disorders. However, the most common cause is wearing poorly fitted shoes with a narrow toe box.
Most patients affected by symptomatic hallux valgus are middle-aged women.
The presence of lesser-toe or other foot abnormalities such as pes planus should also be noted. These are used to classify the severity of the deformity and to determine the type of correction required in the event of surgery. Treatment of hallux valgus must be individualized, since the degree of deformity is not always consistent with the severity of symptoms. In fact, many patients with a severe deformity are asymptomatic. Footwear that fits properly is important in the initial management.