Musculo-skeletal   [back to the Category]

Hallux Valgus   [read the french version]

Author :   Docteur Anne Thiescé

Hallux valgus

Ballet, in France, has only one recognized occupational illness – the hallux valgus. It affects 89.1% of female dancers.

Hallux valgus is a deformation of the fore-foot commonly known as a bunion.

Anatomically it corresponds to a deformation of the 1st row combining the valgus of the big toe and the varus of the first metatarsal. It occurs mainly on Egyptian feet; feet where the big toe is longer than the second one.

There are numerous aetiological factors in ballet:

-dancing on points and the narrowness of the ballet shoes,

-congenital hyper-mobility,

-compensation for external hip rotation insufficiency by middlerolling the foot and pushing the big toe into a valgus position,

-muscular insufficiency of the fore-foot muscles, caused, in particular, by prolonged exercising in ballet shoes which are too tight,

-the common foot pronation and eversion in point position,

The hallux valgus is generally well tolerated amongst female dancers.

Treatment must be medical: modification in footwear, local massages, strengthening of the intrinsic musculature of the foot, sometimes the wearing of a strapping.
Surgical treatment is only suggested under exceptional circumstances. The stiffening of the first metatarsophalangeal which is common after surgery, in fact, makes the "demi-pointe" position impossible.


Bibliography:

Costes F, Desoilles H, Illouz G, Chavy AL. Appareil locomoteur et danse classique. Rev Rhum et Mal ostéoarticulaires 1960; 27: 259-267.

Groulier P.: Traitement chirurgical de l’hallux valgus et des métatarsalgies associées. In "le pied" Actualités en médecine chirurgie et rééducation sous la dri. Chiron P. et Uthéza G. Masson 1991.