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Hate Looking At Your Feet? Part 2: Bunions

Last week we talked about how claw toes and hammertoes might make your feet unsightly and painful. This week, the topic of conversation is BUNIONS!

You might notice, either on yourself or someone else, that the big toe makes a sharp angle in and collides with the second toe. This is a bunion, medically known as hallux valgus. It's possible that at first you never noticed because you thought it was hereditary because one of your parents had it. It's also possible that you didn't care about how it looked because it never bothered you.

Now all of a sudden the boney growth on the outside knuckle of that big toe has started to hurt. It might be painful to the touch or to walk with shoes on. As is progresses, it starts to look worse and worse and becomes increasingly more painful.

So what are the common symptoms of bunions? In general, they're the same as our other toe dysfunction symptoms. The only big difference is wearing thonged sandals or flip flops is typically uncomfortable and toe socks are hard to put on. But the main symptoms are:

  • Foot/feet look visually off and the big toe is unable to straighten

  • Callouses on the big toe

  • Painful to walk

  • Painful to touch

  • Irritated in tight or cramped shoes/heels

Causes of bunions:

In part 1 of this series (find it here), we talked about environmental and task-driven causes for some of our foot ailments. Often times, it's our habits that become destructive to us. It's not always our genetics.

Bunions are usually symptoms or negative by-products of many variables that have gone awry such as in the hips, knees, ankle/foot structure. The problem has been, in my opinion, misclassified as hereditary. Some medical professionals have no idea what causes it or say it's simply a boney deformity.

My theory is that it has something to do with nurture more than nature. Walking can be a learned behavior from infancy when you imitated your parents' walking pattern. You can find my other blog on the development of our walking pattern here. This may be why it appears to be genetic.

Regardless of whether the above is even true, there is a common problem with the bunion victim's gait or walking pattern. Addressing those will help decrease the chances of having that big toe bend in more, causing even more irritation.

Link in part 1, shoewear is important. Narrow, close-toed heels or shoes or overuse of thonged sandals will alter your walking mechanics.

Walking is the most repetitive activity to our bodies

Bunions aren't so much a problem until they start to hurt. Many people opt for surgery to correct them. But surgery doesn't correct walking habits. The same pressures on the body begin pushing from outside to inside, reforming the boney defect that you once dreaded and hated.

I like to think that misplaced weight on the big toe and a rolling motion over the big toe keeps pushing it inward. This is very possibly the reason why after surgery, bunions redevelop.

So what can be done about it?

These are generally the treatment options for bunions:

  • Surgery

  • Injections

  • Pain pills

  • Footwear change

  • Manual therapy

  • Taping and exercises

  • Habit Changes

Who do you call? Toe-busters...? Most people call the podiatrist or the orthopedic surgeon when their bunions start bothering you. Changes in footwear (think those ugly orthotics) and/or injections are recommended. The most common intervention, however, is surgery--to chop off the bone/soft tissue and reset the position of the big toe. The recovery can be anywhere from 6 weeks to 6 months and is usually a pretty painful one. The success of these surgeries varies. In my experience, many of them fail because resetting the bunions isn't the fix. It's a short term solution for a really big, long-term problem that's been around as long as you could walk.

Whether you have had an unsuccessful bunionectomy or you are thinking of having surgery, there are good methods out there using manual therapy as an alternative.

Therapists use many different techniques depending on what exactly caused the alteration of the foot and ankle mechanics. In general, therapists want to mobilize and stabilize the bones and joints in the foot and ankle to give it a stronger structure. But each individual body and foot requires a thorough assessment.

Foot structure changes can be visible in 2-3 sessions, but it's all about treating the whole body so you don't fall back into bad habits and gait patterns.

Your toe is the last joint activated in the motion to propel and it can only be as strong as the weakest link ahead of it in the chain. So treating dysfunctions at the hips, knees, ankle and foot structures is a must.

After your body's foundation and mechanics are improved, the hard work begins: retraining how you walk so that you are safe and efficient and keep those feet happy! You can see how successful manual techniques can be above. These were Rehab and Revive's results after just 3 sessions! Keep in mind that results may vary depending on the severity, but it's great news for anyone wants to avoid the knife!

Remember, we can and we will get those bunions better together!

Dr. Justin C. Lin

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