Bunions

Bunions are one of the most common forefoot deformities. A displacement of the bone under the big toe occurs, which causes the big toe to move towards the smaller toes. This shifting of the bones causes a bony prominence on the side of the patients foot (the bunion joint). Over a period of time the big toe may come to rest under (occasionally over) the 2nd toe.

Causes of Bunions

  • The most important causative factor is poor fitting footwear, such as too short or pointed toe shoes. This accounts for a higher incidence among women than men.
  • Family history of bunions.
  • Abnormal foot function, excessive pronation (excessive rolling in of the foot at the ankle joint while you are walking).
  • Poor Balance.
  • Ankle stiffness.
  • Big toe stiffness.
  • Rheumatoid or osteoarthritis.
  • Muscular imbalance.
  • If the ligaments in the feet are very weak.
  • In some cases, bunions can occur due to trauma or injury to the feet.

Symptoms

  • Include redness, swelling & pain which may be present along the inside margin of the foot.
  • The patients feet may become too wide to fit into their normal size shoe & may experience moderate to severe discomfort when the patient is wearing tight shoes.
  • Corns & calluses may occur on the soles of the feet, in between toes & on the bunion joint.
  • Stiffness  can occur at the big toe due to secondary arthritis, this is known as Hallux Rigidus.
  • Other foot conditions can occur such as ingrown toe nails & in severe cases the bunion joint may have a fluid filled sack called a bursitis This can be very painful & can become infected.

Treatment  

Firstly Consult with a Podiatrist or a Physiotherapist to have the area assessed.

  • Proper fitting shoes.
  • Improve foot function such as balance.
  • Fix stiff ankles by joint mobilisation to regain range in ankle joint to reduce compensatory pronation.
  • Improve range of movement in big toe joints by joint mobilisation.
  • Correct muscular imbalance with an exercise programme designed by the Physio or Podiatrist.
  • Custom Orthotics or innersoles can help reduce further progression of the bunion.
  • If your bunion becomes painful, red & swollen, try using ice on the joint & elevate the foot on a stool.
  • Bunion Night Splints & exercises can reduce the size of the bunion or prevent further progression of the deformity.
  • In some cases surgery, might be necessary. Post-surgical rehabilitation with your Physiotherapist involves addressing pain & swelling & some of the contributing factors such as faulty biomechanics & muscle imbalance. Orthotics after surgery may assist to prevent the bunion returning.
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