Bunions – Hallux Abducto-Valgus (H.A.V)

What is it?

BunionsHallux abducto-Valgus is a progressive disorder that is characterised by a large bump on the inside of your big toe (hallux). With the condition, the hallux is forced to lean towards the 2nd toe and causes the head of the 1st metatarsal bone to not sit correctly in the big toe joint (1st MPJ). As individuals with HAV often walk differently to reduce pain levels, the joint progressively becomes more unstable and can eventually lead to severe arthritis. Although often pain free in its early stages, HAV can be a debilitating condition later in life and therefore early treatment to slow the progression is recommended.

Why did I get it?

HAV can be caused by many factors & can be seen at any stage in life (women > men). Most patients with the condition often present with many of the following risk factors;

  • Feet that roll in (pronate)
  • Sudden weight gain
  • Incorrect/tight footwear
  • Biomechanical foot issues (hereditary)
  • Previous trauma to joint
  • History of Osteoarthritis

How is it diagnosed?

A thorough clinical examination will most commonly diagnose and grade HAV. Depending on severity of symptoms/stage you may be referred for an x-ray to determine the extent of the deformity and to rule out additional pathologies.

Possible Treatments:

  • Footwear advice
  • Padding/strapping
  • Custom Orthotics
  • Foot Mobilisation
  • Neuromuscular needling
  • Night splints
  • Anti-inflammatories
  • Surgery


Although HAV is a progressive condition, successful results are often achieved through early conservative intervention. As it is essentially Osteoarthritis, the progression can be slowed down via controlling the forces and promoting movement through the joint. Surgery is rarely recommended as success is not guaranteed and is associated with a long/painful recovery time.

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