Navigating the beastly bunions…

August 31, 2011 Posted by Dr.Chang

Bunions, also known as hallux valgus or hallux abducto valgus, are commonly known as unattractive big red lumps on the first toe joint, making it painful to wear shoes or engage in the activities you love, like running. But the most important thing to know about bunions is that they are symptomatic of a change in the structure in the front of the foot.  Bunions crop up when another underlying cause makes the big toe lean toward the second toe, throwing bones out of alignment, causing the laxity of muscles and ligaments, and various other misalignments in the foot. In turn, as the big toe moves inward, the bursa sac, the fluid-filled sac that covers the joint, becomes more exposed and increasingly inflamed – and that’s the big red painful lump. Because a bunion is caused by a deformity in the foot, it is essential to consult Blue Ridge Foot and Ankle Clinic for a diagnosis and proper treatment plan.  Dr. Murray and Dr. Chang can help you work with your bunions and their underlying causes, finding the proper balance of treatment, rest, and methods to get back to the activities that you love.

WHAT CAUSES BUNIONS?

Bunions are most often caused by inherited faulty mechanical structures of the foot. The lump itself isn’t inherited, but the faulty foot structure that makes feet prone to developing bunions. Hereditary factors could include congenital foot shape, congenital foot bone structural relationships, ligament laxity, overpronation and equinus. Environmental factors, like shoes that crowd toes, won’t cause bunions, but they may make the deformity get worse at a faster rate, making signs and symptoms appear earlier.

BUNION SYMPTOMS

Symptoms usually only crop up after the deformity has progressed enough for the bunion’s bump to appear. These symptoms include foot pain, soreness, inflammation, redness, a burning sensation and numbness. They occur most often when wearing shoes with a tight toe box, crowding at the toes, or high heels, spending long periods of time on your feet can also aggravate the symptoms.

Such symptoms aren’t always on the joint just below the big toe. A related problem, Tailor’s Bunion, or a bunionette, is a similar deformity – a prominence of the fifth metatarsal bone at the base of the little toe. This deformity is similar to bunions, but is not as common. Similar to bunions, bunionettes are caused by a change in the foot’s bony framework, resulting in the development of the bump or enlargement. Bunionettes require much of the same diagnostic and treatment methods as bunions.

TREATMENT PLANS

Some bunions progress faster than others, so treatment plans may vary. Sometimes, all you need is to observe that your foot is forming a bunion so that you can treat it in a way that it prevents further injury, which primarily focuses on fitting your foot with proper custom made orthotics. A treatment plan might also include (1) making sure you’re wearing the correct shoe wear – shoes with a wide toe box and not wearing (or limiting the use of) pointed shoes or high heels which will make the bunions worse; (2) padding the area to minimize pain, to be obtained from your podiatrist or purchased at the pharmacy; (3) activity adjustment, which means staying away from activity that triggers the pain, including standing for a long time; (4) NSAIDs to reduce inflammation; (5) Icing; (6) injection therapy (for treating the inflamed bursa sometimes seen w/ bunions). It is important to realize that these treatments will not reverse the bunion deformity; they will only slow the rate at which the deformity progresses.

Surgery is needed when other treatment options do not relieve bunion pain and when the pain disrupts daily activities and will focus on the reduction of pain. The procedures will remove the bump of the bone, correct changes in the framework of the foot, and correct soft tissue changes that may have occurred. The surgical procedure will depend on the degree of problems based on X-rays, your age, your activity level among other factors. The length of recovery, time off your feet, and time before you can go back to work, and time before you can drive will differ depending on the procedure(s) performed among other factors. Most patients will experience discomfort for three to five days after the surgery, depending on the procedure conducted.  Follow instructions from your podiatrist to minimize post-operative pain.

Bunion surgery generally has an incredibly high success rate, but long-term success depends on your prolonged dedication to having healthy feet. Get rid of those 4-inch heels and taper-toed pointy shoes, and find shoes that fit you, with padding and over the counter or custom-made orthotics that are right for you. A physical therapy plan may also help to strengthen your foot and to increase its flexibility.

HOW WILL BUNIONS AFFECT MY RUNNING AND OTHER ACTIVITIES?

As this article has explained, bunions are a progressive condition caused by another deformity in the foot. The underlying deformity will probably not slow you down until the bunion appears. The bunion itself may be painful as it rubs against your shoe or throbs when you put impact on it. In the worst cases, bunions can be prohibitive of running. However, if you diagnose their underlying cause early enough, and invest in a treatment plan, your podiatrist can help you can keep the condition at bay so you can keep doing the activities that you love…in moderation!

If you do choose to run with bunions or after your recovery from bunion surgery, you can try a few techniques to decrease the pain. Taping your foot in the normal position before running can help reduce the stress and pain on a bunion. Toe separators between the big and second toe and taping the pad to your big toe have been reported to relieve some pressure from that area of the foot. Toe exercises can help increase blood flow to the joint, such as toe adductions (pull your big toe out to the side away from other toes and hold for a second or two and repeat 10 times on each foot) and toe extensions (raise your big toe and curl your toes tightly down toward the bottom of your foot, use your hand to gently push down on toes, flexing each toe individually or your toes as a group, and hold for two seconds doing ten repeats on each foot). These stretches will not cure the bunion condition or deformity, but they may help reduce pain in the short-term. Be sure to discuss these methods with your podiatrist and physical therapist to find the proper treatment plan for your individual needs.

The most important thing you can do to take care of your feet long-term is to buy the proper footwear for activities and everyday wear. Feet with bunions require a few main considerations when buying the proper shoes: foremost, since bunions are indicative of foot deformities, your feet require supportive shoes. Second, there are a variety of shoes made with wide toe boxes and snug fitting heels that are good for runners with bunions and bunionettes. Depending on your foot, you may need supportive shoes, shoes with more cushioning, motion control, mesh material, and so on. Your local shoe dealers, Ragged Mountain Running, the Charlottesville Running Company, Crozet Running, and Richey and Co. Shoes, can all provide foot assessments and expert advice about properly fitting shoes.

Above all, remember that the first step to treating your foot pain is visiting your podiatrist to diagnose the underlying cause of your bunions. With the help of your Charlottesville or Waynesboro podiatrist, you can arrange a proper treatment plan to prevent further wear and tare on your feet and to slow down the progressive deformity that your bunion is indicating. Visit your Charlottesville or Fishersville podiatrist for a diagnosis and integrated treatment plan that is right for you.

Comment on this post to share your story about running with bunions or contact Blue Ridge Foot and Ankle Clinic. We’d love to hear from you!

Blue Ridge Foot and Ankle Clinic
              Charlottesville Podiatrist Location: 887 A Rio E Ct., Charlottesville VA, 22911 (434) 979-8116
              Waynesboro Podiatrist Location: 417 S. Magnolia Waynesboro,VA 22980 540-949-5150
 
Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years.Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.

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