Bunions are also known as or related to Hallux Abducto Valgus (HAV), big toe joint pain, big toe joint bump, angled big toe, deformed big toe, big toe bump.
Description
A bunion refers to the thickening of bone around the big toe joint that is ofter accompanied by a change in angle of the big toe itself. The bony thickening of this joint is extra bone that the body is applying to each side of this joint to reinforce this area. Extra bone indicates that extra pressure is going through this joint and needs to be addressed.
Before you consider surgery, there are many things that can be done to relieve the pain and slow the progress of this condition. These things need to be considered given the difficult nature of effective bunion surgery, the prolonged recovery and the high recurrence rates after surgery.
Causes
Bunions are said to be 'inherited', however the important thing to note is that the risk factors for a bunion are usually inherited and the same processes begin to happen that results in the formation of bunions.
The single biggest factor that is in our control is the amount of flexibility through the big toe joint with walking.
Some people have plenty of flexibility through the big toe without weight through their feet, but as body weight is applied, the big toe becomes stiff due to the way the foot is functioning. With the amount of body weight going through this joint and the number of steps per day, it is easy to see why this is the biggest factor to be addressed. Instant pain relief is achieved and the progression of this problem can be reduced when this flexibility of the big toe during gait is addressed.
Big Toe Flexibility Needed For Short and Long Strides
The amount of flexibility of the big toe for gait depends on the stride length (how fast you are walking or running), inclines such as ramps/hills, heel height of the shoe (higher the heel, more bending required) and the type of activity performed (repetitive crouching with work or lunges/push up position with training).
Other Risk Factors For Bunions / Big Toe Joint Pain:
- Heel height
Extra flexibility is required for higher heels and the toe already has reduced flexibility.
- Relaxed ligaments (ligamentous laxity/hypermobility)
Loose ligaments in the feet lead to poor foot function, less felxibility and less stability to keep the big toe straight.
- Flat feet
Feet that roll inwards cause the ligament under the arch to tighten and reduces flexibility through the big toe.
Big Toe Flexibility Without Weight Through Foot
Big Toe Flexibility With Weight Through Foot
These pictures demonstrate how some feet tighten under the arch and the big toe with weight bearing which has the effect of preventing the big toe joint from bend effectively. This created stiffness places a huge amount of force through the big toe joint leading to pain, hard skin and bone being deposited on the joint to try and reinforce this overloaded joint.
As the bone thickens, the joint becomes stiffer, increasing the force through the joint, increasing the bone thickness and this cycles up to form bunions.
Treatments
Addressing foot function through the use of footwear, orthotics and specific orthotic designs to improve the flexibility of the big toe joint when walking is critical. Instant pain relief can be achieved as well as slowing the bunion process when force through the big toe joint is reduced.
For difficult cases, the shoe can be made stiffer to provide instant pain relief and protection of the joint. We use extremely thin and stiff carbon fibre foot plates that slip into the bottom of shoes. This allows us to customise how much we let the front of the shoe bend with walking, running or training. These new devices have been amazing to help us manage the most difficult cases.
If you need help with bunion, big toe joint or hallux abducto valgus problems, book in to see one of our experienced sports podiatrists at Shoes Feet Gear.