Do you have a Bunion that needs checking?
Have you developed a lump or bump at the side of your big toe joint? Are you getting pain in your big toe joint? You may be asking yourself – Do I have a bunion?
What are bunions?
A bunion is a broad term that describes the deformity of the big toe joint, the 1st Metatarsophalangeal Joint (MPJ). The technical name is Hallux Abducto Valgus and in laymans terms simply describes the deviation of the big toe towards the centre of the foot and the smaller toes (toes 2-5).
In many cases, bunions are a progressive deformity and get worse over time. As the bunion deviation progresses a bony growth may develop at the bunion site causing a bump or an enlargement on the side and over the top of the big toe joint. The surrounding skin can also become reddened, swollen and painful and osteoarthritic changes to the joint can occur.
As the toe deviation progresses shoe fitting can become increasingly difficult and can further contribute to the development of pain. Bunions can make you feel embarrassed about your feet or that your feet look ugly because of the changes in foot shape.
What causes bunions?
Bunions are caused by a variety and combination of factors that include family genetics (hereditary factors), shoes, physical activities and most importantly foot alignment.
Family Genetics – Hereditary Factors
Hereditary factors are biological traits that are passed down via genetics from our parents. These traits often relate to misalignment of joints of the feet and legs and this can affect the way the muscles pull on the big toes and the resultant forces loading through the big toe when someone stands and walks, and this can ultimately lead to a bunion.
So many of the shoes available for women (and some men’s shoes) are designed for fashion not necessarily function and the typical high heel is tapered at the front and has room for three toes not five. The higher the heel the more pressure that is directly placed on your big toe and as a result can accelerate a deviation of the big toe toward a bunion. If you have the wrong genetic makeup and subsequent foot mechanics habitually wearing the wrong shoes can dramatically increase your risk of bunion development.
Physical activities – sport or exercise
The problem with increased activity levels and sports occurs when you have genetic and bio-mechanical tendencies that increase the load and stress to the big toe and this can increase bunion development over time. The best thing to do in terms of physical activities is to undertake a variety of activities – this varies the repetitive stress on the feet and toe and can help to reduce the risk of bunion changes.
Foot mechanics and alignment
A foot that excessively pronates (rolls in) can result in extra pressure on the big toe during toe push off in the walking cycle. This extra stress on the big toe can push it out of alignment when you stand and walk and can ultimately lead to bunion development.
This also means if you can improve the alignment of the feet and legs and strengthen the relevant muscles around the joint you can actively treat and improve the bunion, especially when treatment is started early.
How can we help bunions?
In order to improve the pain and to stop the bunion from becoming worse, Foot Mobilisation Therapy (FMT) and corrective exercises can be used to stabilise the foot and make it stronger. FMT helps to realign the big toe and corrects the structure of the foot, allowing the foot to work as nature designed it to. This can reduce the pain and discomfort.
Mobilising the big toe joint also increases the production of synovial fluid, which is the oil for the joint. By increasing the production of synovial fluid, the joint can work more efficiently, with less pain. This also has the added bonus of decreasing the risk of osteo-arthritis within the joint.
If the bunion is advanced and there has been extra bone growth because of the toe displacement our services can’t remove the extra bone and this can only be removed via surgical intervention. This is where a detailed assessment of your goals and situation will allow us to make the best treatment recommendation for you.
Should I have surgery?
In cases where the bunion is identified and treated early surgery can often be avoided. Surgery can be indicated and effective at addressing the cosmetic appearance of the bunion by removing the bone. However, this needs to be weighed up against your individual goals, pain level and risks of a surgical procedure (time for recovery and time off work, pain, infection and other complications). Surgical assessment and advice is best discussed with an orthopaedic or podiatric surgeon.
Whether you have surgery or not it is strongly recommended that you have your foot mechanics checked. If you fail to address the underlying drivers of your bunion development and the same foot function patterns continue there is a high probability that your bunion can redevelop over time – remember treat the cause not just the symptoms.
What are Hammer Toes and Claw Toes?
Hammer or claw toes are where the toe bends excessively in the middle joints resulting in a deviated shape and alignment leading to a claw or hammer appearance.
What causes hammer toes?
Causes of hammer toes include inherited foot types, poor foot bio-mechanics and function causing contraction of muscles and ligaments making flattening and extending of the toes difficult. Some arthritic conditions such as rheumatoid arthritis can also have an impact. Over time bone changes can also occur.
How can we help Hammer Toes?
Using a combination of strengthening, stabilising and stretching exercises and Foot Mobilisation Therapy (FMT) the toes clawing and hammer positions can often be reduced leading to better shoe fit, comfort and function.
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