What are bunions ?
The medical term for a bunion is Halluxabductovalgus. It is when the big to diverts towards the second toe. It can also have a swollen bump on the inside of the big toe joint. Bunions have been known to be caused from high heel shoes. Did you know bunions can be hereditary in the sense that foot type can be hereditary? Did you know there are conservative (strength, footwear, modalities) and more aggressive (surgery) treatment options? Certain types of feet are more prone to this and yes, high heel shoes can advance the progression of a bunion.
Here at Downtown Toronto Podiatrist and Downtown Physiotherapist, we can help reduce pain, prevent the progression and educate on the matter.
How do Bunions Form?
Bunions are caused by abnormal repetitive forces placed on the big toe joint, specifically when walking, running or standing. Specifically, pronation, when the foot collapses inwards.
Weakness in the hip can contribute to the ankle rolling in, adding more strain to the big toe joint. Here at our Downtown Toronto Podiatrist clinic, we believe that foot pain can because by imbalances and weakness in the foot, but also the way the foot interacts with the hip and leg.
Weak Hips, What Else?
Weak toe push off and the ability for the ball of the first ray( ball of the foot) to firmly plant to the ground and stabilize the foot during stance and push off is important for normal function. When this is impaired, injury can arise. Thus, strengthening this mechanism helps mitigate bunion formation. If the foot is weak, the foot becomes unstable and the first ray becomes, hypermobile. When this happens the joint jams, causing pain and cartilage damage. Cartilage damage can turn into osteoarthritis.
Strengthening the First Ray Also Strengthens the Arch
The first ray is important to be strong during landing and toe off. Strengthening that part of the foot helps to strengthen the main muscles of the foot and arch. This can be done with isometric exercises and with banded exercises. Everything we do for strength should be applicable to everyday movements, so gradually executing those movements to mimic walking and running should be the goal. Example can be pressing the ball and toe firmly to the ground for 45 s – 1 min with 4-5 reps while seated. Then progressing to do this while standing, to standing on one leg. Then executing this when doing calf raises and consciously thinking of this when walking and running.
Footwear and Bunions
Pain can be caused from footwear as well. It is important to avoid wearing shoes that are too narrow, which can push the toe into the divergent position. When the foot is in that divergent position it is not able to function properly and can weaken. Not only that, but pressure placed on the side of the toe joint can cause irritation to a pad around the joint. That pad around the joint is called a bursa and it can become very inflamed and painful when excessive pressure is placed on it.
Initially the main goal is to get the pain down. This is done by reducing activities that aggravate the area, icing , antiinflammatories. In cases where the bursae is very inflamed and swollen, corticosteroid injections do well to help with calming the inflammation down.
Some people like to wear a night splint, to help stretch the joint capsule. This can make it feel nice, however it is not addressing the mechanics when walking and running, when the trauma to the joint is happening.
Toe spacers, work wonderfully for aligning the toe. These are an excellent choice to wear even when you have to wear high heel shoes. It helps prevent the toe from getting pushed over to the side. People can run and walk with these on.
This is a big one. A good approach is to be assessed by a chiropodist, podiatrist or physiotherapist near you. Here at our Downtown Toronto Podiatrist and Downtown Toronto Physiotherapist office, we feel it is important examine hip mobility , strength of the glutes, calf , foot, big toe strength and a gait analysis.
Orthotics and Footwear
There is a time and place for orthotics. Not everyone needs orthotics, however when there is pain, orthotics are a great tool to help keep you moving while you manage your injury. Orthotics help to prevent abnormal foot motions, caused by improper mechanics.
It is always a good idea to choose footwear that is appropriate for the individual.
What does that mean? It means if you are suffering or recovering from a foot injury, minimal footwear does not provide enough support for your injury. Footwear with adequate support helps take off excessive load that would be placed on the foot, if barefooted.
It is also important to try to not go barefooted in the house when recovering from a foot injury. There are many brands that make suitable footwear comfortable to wear inside the house.
If you are suffering from bunion pain and are looking for Bunion Treatment, our Downtown Toronto, Podiatrist and Downtown Toronto Physiotherapist we would be happy to help keep you moving !