Bunion pain

Bunions
What are bunions?
Bunions (medical term “hallux valgus”) are formed when the big toe drifts in the direction of the second toe, forming a painful and abnormal joint angle. Similarly bunionettes are formed when the ‘pinky’ toe drifts in the direction of the big toe. Bunions are sometimes quite painful, especially when bony enlargements form as a result of the strain at the joint. Bunions often cause increased calluses and blisters joint area because of faulty walking and running biomechanics.

What causes bunions?
Bunions are often caused by prolonged wearing of faulty footwear. Serial offenders are pointy toed shoes, heeled shoes and boots with narrow footbeds and dress shoes. Bunions can also be formed gradually over time with wearing too narrow of a shoe for your foot type.

How to tell if your shoe is too narrow for your foot
Place your foot on a piece of paper and draw around the perimeter of it. Now take your shoes’ insole and lay it over your drawing (if no insoles then cut out your drawing and lay it over the top of the shoe). Ideally your shoe should be wide enough in the forefoot to accommodate the width your drawing. If not, you’re wearing too narrow of a shoe.

How can bunions can alter your running and walking mechanics
Bunions can limit how far the big toe can extend backwards. (Try this experiment: take your big toe and pull it upwards, you should be able to get at least 50 degrees of bending) This has huge translations to whether the ball of the foot can bend during uphill walking/running during toe-off. If range of motion here is limited by a bunion, the result is eversion (or pointing out) of the foot and excessive pronation. The spinning of the ball of the foot as pronation occurs is what causes blisters and calluses to form. Over time, other complications arise: plantar fasciitis and possibly knee pain.

What to do if you have bunions
- First of all, get into a good pair of wider shoes. Use the cut-out method above to find one that fits. Don’t be afraid to bring your cut-out to a reputable shoe store so you make the right purchase.
- Physical Therapy may be able to help with guidance towards joint mobilization and stretches/exercises for a few visits, but the solution tends to be a long-term one. Changing your daily footwear habits would be the most useful defense to bunions.
- There are many splints and devices on the market to help reverse the angle and improve range of motion of the toe joint. One that we’ve tried, tested and trust is “Correct Toes“. (ask us how to get free shipping)

What if the bunion pain is really bad?
We suggest you consult with a podiatrist. They can further delineate whether you need more invasive procedures. The rehab from some surgeries can be long, but some surgeries have shown to be effective in eliminating the pain. Just ask us for a referral and we can point several trusted podiatrists your way.

By Alice Holland, DPT.
Alice’s Google + page.


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