Bunions

What are bunions?

Bunions are a deformity of the 1st metatarsophalangeal joint called Hallux Abducto Valgus (HAV). The bump or bunion is formed when the head of the 1st metatarsal loses its stable connection with the big toe and so protrudes outwards. This process usually starts from instability of the foot further back at the 1st metatarsal cuneiform joint. Overtime, we see the big toe deviate further toward lesser toes as the supporting ligament structures are stretched and muscles weakened. The change in alignment of these bones and joints can result in premature wear on joint surfaces. As a result, this causes arthritic changes such as joint stiffness, pain and further bony deformity as well as contributing toward other toe deformities such as hammer and claw toes.

There are a variety of non-environmental and environmental factors that can contribute toward a bunion deformity.

• Genetics – Bone shape, bone length and ligament laxity
• Footwear – Poorly fitted, narrow toe box and high heeled shoes
• Biomechanics – Walking or loading patterns through the body and feet
• Occupation, Activity and Hobbies – Those that may require poor fitted footwear or excessive load through the foot eg. ballet
• Previous trauma – Damage to the bones and joints from injury or surgery
• Arthritis
• Inflammatory diseases

For treatment of this condition, catching it early is the key. Some people inherit a foot structure that may predispose them to getting bunions. However, if detected early enough we can improve the function and stability of the feet, manage and modify load through the joints, and also prevent further progression of the deformity. If left too long or if stiffness and pain are present, surgery may be indicated.

Some of the treatments you may receive for bunions include:

• Strengthening exercises for the feet, lower limb and hips
• Mobilisation and stretching techniques
• Foot strapping and bracing
• Toe separating devices
• Footwear advice
• In shoe padding and custom orthotic inserts

Hammer and Claw Toes

These are toe deformities that occur in the lesser toes of the foot.

Contributing factors can range from;

• Footwear shape and fit
• Biomechanical patterns
• Trauma, and
• Arthritis

Hammer and Claw toes can also occur secondary to other foot deformities such as HAV. They are usually associated with an imbalance between the flexor and extensor muscles of the lower limb and foot. The toes flex to grip the ground during push off for stability because the foot is poorly controlled by other intrinsic foot muscles. If left untreated, it can lead to further injury like HAV.

If you have concerns about bunions or other toe deformities, we encourage you to book an appointment with our Podiatrist. They will perform a full history and assessment as well as work with you to create a customised treatment plan. As a result, this can help you stabilise and prevent further progression of these conditions. Call (07) 3511 6352 or send us an online booking enquiry!