Specialista in Ortopedia Pediatrica
Juvenile hallux valgus
Home Exercise Program
Not every exercise listed here is suitable for every child: the selection is individual and is defined during the consultation.
1.Toe yoga (big toe control)
Strengthens muscles that keep big toe aligned
Seated or standing, foot flat on floor. FIRST MOVEMENT: lift ONLY big toe keeping other 4 toes pressed down. SECOND MOVEMENT: lower big toe and lift other 4 toes. Alternate with control. Focus on moving big toe INDEPENDENTLY from other toes. This activates abductor hallucis, the muscle that counteracts deviation.
15 reps per movement, 2-3 times daily
2.Active toe spreading (toe spreads)
Activates abductor hallucis to counteract deviation
Foot flat on floor. Try to SPREAD all toes as wide as possible, like a fan opening. Then relax. In particular, focus on moving big toe inward (away from other toes). Initially may be very difficult — brain needs to "re-learn" this movement. With consistent practice it improves significantly.
10-15 reps, 2-3 times daily
3.Short-foot (active arch)
Strengthens arch and big toe support musculature
"Shorten" foot creating dome with plantar arch without curling toes. Toes stay flat! The arch lifts. This exercise engages deep foot muscles, including abductor hallucis, essential for counteracting valgus deviation.
10 reps × 5-10 second holds, twice daily
4.Object pick-up with big toe
Functional big toe grip strengthening
Scatter small objects on floor (marbles, pencils, fabric pieces). Pick them up using big toe and second toe as "pincers". This strengthens big toe grip and muscles that stabilize it in correct position. Variation: roll up towel using only big toe and second toe.
10-15 objects per foot, once daily
5.Single-leg balance with big toe focus
Activates big toe stabilization during loading
Stand on one foot. Focus on weight distribution: make sure big toe is actively pressed down and participating in stabilization. Often in feet with hallux valgus, weight shifts outward. Correct by bringing attention to big toe loading. Progression: eyes closed, soft surface.
3 × 30 seconds per foot, 1-2 times daily
6.Manual big toe mobilization
Maintains joint mobility and counteracts lateral soft-tissue tightness
Seated. With one hand stabilize the forefoot (without pressing on the painful bump), with the other gently grasp the big toe and move it outward, away from the second toe, until a gentle tension is felt but no pain. Hold the position. Add small flexion and extension movements of the joint. Never force.
10 reps × 20 seconds, 1-2 times daily
7.Big toe abduction with elastic band
Active strengthening of abductor hallucis against resistance
Seated with feet on the floor and a loop band around both big toes. Keeping the heels still and together, move the big toes apart against the band resistance, keeping the other toes relaxed and the feet flat. Hold 3-5 seconds and return slowly. If the band is too stiff, bring the feet closer together.
3 × 10-15 reps, once daily
8.Towel curls (toe flexors)
Strengthens the plantar musculature supporting the forefoot
Seated, foot on a towel spread on the floor. Using only the toes, curl the towel toward you, then push it back by extending the toes. Keep the heel still on the floor. To progress, place a small weight (book) on the far end of the towel.
3 sets per foot, once daily
9.Plantar release with a ball
Reduces plantar fascia tension, often increased in hallux valgus
Seated, slowly roll a tennis ball (or small firm ball) under the sole, from heel to forefoot, for 2-3 minutes. Pause a few seconds on the tightest spots with tolerable pressure. Avoid pressing directly on the painful bump if tender.
2-3 minutes per foot, once daily
10.Calf stretch
A tight calf increases load and valgus thrust on the big toe
Facing a wall, leg to stretch behind with the heel firmly down and the toes pointing straight ahead. First version with a straight knee (gastrocnemius), second with a bent knee (soleus). Push the hips forward feeling the calf lengthen. Do not turn the foot outward to increase the stretch.
3 × 30 seconds per position, 1-2 times daily
11.Calf raises with big toe control
Trains correct push-off through the big toe during gait
Standing, hands on the wall. Rise slowly onto the toes making sure weight passes through the BIG TOE and second toe, not the outer border of the foot. The ankles must not roll outward. Rise in 2 seconds, lower in 3-4 seconds. Check technique in a mirror or with a parent.
3 × 12 reps, once daily
RED FLAGS - When to stop and contact the doctor immediately
Stop the exercises immediately and contact the specialist (or go to the emergency department if severe) if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
- Fever, redness or warmth of the joint, or inability to bear weight
In case of doubt, always prefer a check-up over continuing the exercises.
Dott. Daniele Priano
Ortopedia Pediatrica - ASST Gaetano Pini-CTO
ortopediaevolutiva.com • 26/08/2026
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MioDottoreBefore You Start
Who is this guide for?
Children and adolescents with this condition, as directed by the specialist. Exercises are general and should be adapted to individual cases.
What you need
Clear floor space, mat or soft surface, comfortable clothing. Some exercises may require resistance bands or supports.
Suggested frequency
Usually 1-2 times daily, as directed during the visit. Consistency is more important than intensity.
Common mistakes to avoid
- •Performing exercises too quickly without control
- •Pushing beyond the pain threshold
- •Skipping days or doing occasional very long sessions
- •Not warming up before strengthening exercises
⚠️ Red flags — when to stop and contact the doctor immediately
Stop exercises immediately and contact the specialist if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
Detailed Exercises
- 1
Toe yoga (big toe control)
Strengthens muscles that keep big toe aligned
Seated or standing, foot flat on floor. FIRST MOVEMENT: lift ONLY big toe keeping other 4 toes pressed down. SECOND MOVEMENT: lower big toe and lift other 4 toes. Alternate with control. Focus on moving big toe INDEPENDENTLY from other toes. This activates abductor hallucis, the muscle that counteracts deviation.
15 reps per movement, 2-3 times daily - 2
Active toe spreading (toe spreads)
Activates abductor hallucis to counteract deviation
Foot flat on floor. Try to SPREAD all toes as wide as possible, like a fan opening. Then relax. In particular, focus on moving big toe inward (away from other toes). Initially may be very difficult — brain needs to "re-learn" this movement. With consistent practice it improves significantly.
10-15 reps, 2-3 times daily - 3
Short-foot (active arch)
Strengthens arch and big toe support musculature
"Shorten" foot creating dome with plantar arch without curling toes. Toes stay flat! The arch lifts. This exercise engages deep foot muscles, including abductor hallucis, essential for counteracting valgus deviation.
10 reps × 5-10 second holds, twice daily - 4
Object pick-up with big toe
Functional big toe grip strengthening
Scatter small objects on floor (marbles, pencils, fabric pieces). Pick them up using big toe and second toe as "pincers". This strengthens big toe grip and muscles that stabilize it in correct position. Variation: roll up towel using only big toe and second toe.
10-15 objects per foot, once daily - 5
Single-leg balance with big toe focus
Activates big toe stabilization during loading
Stand on one foot. Focus on weight distribution: make sure big toe is actively pressed down and participating in stabilization. Often in feet with hallux valgus, weight shifts outward. Correct by bringing attention to big toe loading. Progression: eyes closed, soft surface.
3 × 30 seconds per foot, 1-2 times daily - 6
Manual big toe mobilization
Maintains joint mobility and counteracts lateral soft-tissue tightness
Seated. With one hand stabilize the forefoot (without pressing on the painful bump), with the other gently grasp the big toe and move it outward, away from the second toe, until a gentle tension is felt but no pain. Hold the position. Add small flexion and extension movements of the joint. Never force.
10 reps × 20 seconds, 1-2 times daily - 7
Big toe abduction with elastic band
Active strengthening of abductor hallucis against resistance
Seated with feet on the floor and a loop band around both big toes. Keeping the heels still and together, move the big toes apart against the band resistance, keeping the other toes relaxed and the feet flat. Hold 3-5 seconds and return slowly. If the band is too stiff, bring the feet closer together.
3 × 10-15 reps, once daily - 8
Towel curls (toe flexors)
Strengthens the plantar musculature supporting the forefoot
Seated, foot on a towel spread on the floor. Using only the toes, curl the towel toward you, then push it back by extending the toes. Keep the heel still on the floor. To progress, place a small weight (book) on the far end of the towel.
3 sets per foot, once daily - 9
Plantar release with a ball
Reduces plantar fascia tension, often increased in hallux valgus
Seated, slowly roll a tennis ball (or small firm ball) under the sole, from heel to forefoot, for 2-3 minutes. Pause a few seconds on the tightest spots with tolerable pressure. Avoid pressing directly on the painful bump if tender.
2-3 minutes per foot, once daily - 10
Calf stretch
A tight calf increases load and valgus thrust on the big toe
Facing a wall, leg to stretch behind with the heel firmly down and the toes pointing straight ahead. First version with a straight knee (gastrocnemius), second with a bent knee (soleus). Push the hips forward feeling the calf lengthen. Do not turn the foot outward to increase the stretch.
3 × 30 seconds per position, 1-2 times daily - 11
Calf raises with big toe control
Trains correct push-off through the big toe during gait
Standing, hands on the wall. Rise slowly onto the toes making sure weight passes through the BIG TOE and second toe, not the outer border of the foot. The ankles must not roll outward. Rise in 2 seconds, lower in 3-4 seconds. Check technique in a mirror or with a parent.
3 × 12 reps, once daily
Frequently Asked Questions
Can exercises correct hallux valgus in children?
Exercises don't correct the bony deformity, but can slow its progression, improve intrinsic foot muscle strength and reduce symptoms. In children the foot is still growing, so maintaining good musculature is particularly important.
Are toe spacers needed for hallux valgus in children?
Night splints can be useful to keep the big toe in correct position during rest, but their corrective efficacy is limited. More useful are muscle strengthening exercises and appropriate footwear (wide toe box). Strategy should be discussed with specialist.