Hallux Valgus: Why Does It Initiate Lower Extremity Malalignment? 1. Collapse of the Windlass Mechanism: The First Misstep in Gait During the late stance phase of walking, the big toe (first metatarsophalangeal joint) dorsiflexes, tightening the plantar fascia and elevating the medial arch—a process known as the Windlass Mechanism . This transforms the foot into a rigid lever to propel the body forward. Biomechanical Problem: As hallux valgus progresses, the first metatarsal head deviates medially while the big toe rotates laterally. Consequently, the first ray loses its ability to bear weight and effectively push off the ground . Compensation: Without this primary lever, the body resorts to inefficient compensatory gait patterns, placing excessive strain on the ankle and calf muscles. 2. Compensatory Chain Reactions: The Breakdown of the Kinetic Chain Instability at the base of the foot does not stay isolated; it propagates upward. Over-pronation: Hallux Valgus is typically accompa...