Bunions

In this month’s blog I’ll be diving into a very common condition called Hallux Valgus aka Bunions. I will be exploring the causes of Bunions, how chiropractic care can help and some exercises that may assist in alleviating symptoms and improving function of the big toe.

What is a Bunion?

A Bunion is a progressive deformity of the big toe joint. This condition involves inward angulation towards the second toe, which over time is accompanied by a prominent bony protrusion at the base of the big toe. Beyond the cosmetic implications, long standing bunions can lead to pain, reduced big toe function and difficulty walking if left untreated.

Common symptoms of a bunion include:

• Pain around the big toe
• Swelling and redness
• Difficulty wearing shoes especially those with a narrow toe box
• Or painless in some cases

What causes Bunions:

There are a range of factors that can contribute to you developing a bunion:

1. Genetics: A family history of bunions increases susceptibility, often due to inherited foot structures like flat feet, hypermobility or Morton’s toe (longer second toe).
2. Footwear: Tight, narrow toe box, unsupportive shoes place undue pressure on the forefoot, which may exacerbate a bunion.
3. Biomechanics: Altered lower limb mechanics, such as overpronation (flat feet), weak foot muscles or uneven weight distribution from a potentially longer leg can lead to increased stress on the big toe/s.
4. Medical conditions: Inflammatory arthritis (e.g. gout) and other connective tissue disorders may predispose individuals to bunions.
5. Gender: Women can be more commonly affected, likely due to footwear choices (high heels) and hormonal influences on joint laxity.
6. Previous trauma: Past fractures, ligament tears or damage to the capsule of the big toe may also lead to bunions

How can we Help?

The team here at My Sports Chiropractor, use a range of different treatment techniques that can help manage painful bunions. Treatment includes:

• Load management and activity modification advice
• Soft tissue work
• Tailored rehabilitation stretches and exercises
• Mobilisations/manipulation to the big toe and surrounding joints
• Dry needling
• Taping
• Recommendation of Orthotics, toe spacers or splints
• Recommendation for the use of Barefoot shoes

What can you do to manage it at home?

We know through research that stronger feet and ankles may help decrease bunion-related pain and its impact on your movement. So here I’ve provided 3 simple yet effective exercises to help with strengthening your feet, in order to improve the pain and function of your bunion/s.

1. Toe raises: 

• Raise up shorten your toes while keeping your heel and the front of your foot on the ground. Hold for 1-2 seconds before returning to your toes back down to the floor. Perform 10-12 repetitions each foot for 3 sets.

2. Toe spread-out:

• Lift and spread your toes while keeping your heel and the front of your foot on the ground. While your toes are spread out, push your little toe down and out to the floor. Then, push your big toe down toward the inside of the foot. Aim to hold this position for 10-30 seconds for at least 3-5 sets.

3. Heel-raises:

• Stand with your knees bent. Elevate your arch while keeping your heel turned in. Then, raise your heel off the floor while keeping pressure on your big toe. You can also progress this exercise by looping a small band around your big toes to hold your toes straight to help correct the bunion. Hold each repetition for 3-5 seconds and repeat this 10-12 times each leg for 3 sets.

NOTE: All these exercises can be progressed from sitting, to standing on both feet, to performing the exercises standing on just 1 leg. Perform these exercises daily for optimal results.

If you’re suffering from a Bunion and would like our opinion, you can schedule a time by booking an appointment online.

Chris Lamacchia

References:

1. Perera, A. M., et al. (2011). “Hallux valgus.” The Lancet, 377(9780), 1559-1571.
2. Kilmartin, T. E., et al. (1994). “Orthotic effect on hallux valgus angle.” Journal of Foot and Ankle Surgery, 33(1), 6-11.
3. Uden, H., et al. (2017). “Conservative management of hallux valgus.” Foot and Ankle Surgery, 23(1), 1-7.
4. Mickle, K. J., et al. (2016). “Foot exercises and their role in managing foot pain and deformity.” Journal of Foot and Ankle Research, 9(1), 37.
5. Treatment of Progressive First Metatarsophalangeal Hallux Valgus Deformity: A Biomechanically Based Muscle-Strengthening Approach” (J Orthop Sports Phys Ther 2016;46(7):596-605
6. Jianhua Ying, Yining Xu, Bíró István and Feng Ren. Adjusted Indirect and Mixed Comparisons of Conservative Treatments for Hallux Valgus: A Systematic Review and Network Meta-Analysis
7. Colò G, Leigheb M, Surace MF, Fusini F. The efficacy of shoes modification and orthotics in hallux valgus deformity: a comprehensive review of literature. Musculoskelet Surg. 2024 Dec;108(4):395-402. doi: 10.1007/s12306-024-00839-9.
8. Zirngibl B, Grifka J, Baier C, Götz J. Hallux valgus : Ätiologie, diagnostische und therapeutische Prinzipien [Hallux valgus : Etiology, diagnosis, and therapeutic principles]. Orthopade. 2017 Mar;46(3):283-296