Tips and Tricks for Bunions (Hallux Valgus)

What are bunions exactly?
Basically, a bunion is a misalignment of the joint at the base of the big toe, where the big toe (Hallux) meets the foot (the metatarsophalangeal joint). This misalignment can cause inflammation, redness, tenderness, and pain. It can also cause additional bone formation. It is a progressive deformity, meaning that it can get worse over time.

What causes bunions?
There are many factors that can contribute to bunions: abnormal foot function and mechanics (such as over pronation - a common cause of bunions in children, abnormal anatomy of the MTP joint, and genetic factors). Abnormal biomechanics can lead to joint and muscle imbalance and instability in the joints, thus causing a bunion. Tight-fitting shoes, especially those with narrow toes and/or high heels, can exacerbate the condition and increase the pain associated with it.

What can you do about them?
A) Try getting some shoes with a wider toe bed and very little, or no, heel rise (minimalist or barefoot shoes, for example). You want space to wiggle your toes. This doesn’t mean you have to throw out all your nice kicks, just use your heels and narrow-toed shoes for special occasions and not as your everyday footwear.

B) Stretch and manipulate your toes, feet, and calves. Keep your feet functional and limber. There are many different things that you can do, so I will just outline a few here:

1. Work on actively sliding your big toe away from the rest of your toes (abducting it) without lifting it off the ground. This is surprisingly difficult. You may need to pin down your other toes and hold your ankle in place to stop the “cheating”. I find it is easiest to do while sitting, so that you aren’t load bearing.
2. Lift up all your toes and spread them apart as much as you can. Then try to put them down one at a time, starting with the pinky toe and working towards the big toe. This is another one that is good to do seated.
3. Massage the area around your big toe; focusing on the space between your first and second toes. You can do this for the rest of the toes too. It is also good to roll out the bottom of your foot. A tennis ball works, or a foam ball such as a lacrosse ball. You can also find balls and rollers made specifically for myofascial release. Finally, roll your calves and shins as well (not directly on the bone). A tight Tibialis Anterior muscle can be a culprit in bunion formation. As you can see from the picture, the Tibialis Anterior tendon attaches on the first metatarsal.

C) You can also buy toe spacers (such as “Correct Toes” and “Yoga Toes”). Some can be worn in your shoes, and others are to be worn for a brief period while barefoot. A few minutes a day can really make a difference.

Even if you don’t have a bunion, these tricks are good for everyone: we all need to show our feet a little more love - they work so hard for us every day! ​