Bunions & Bunionettes
What is a bunion?
A bunion is one of the few foot conditions you can simply look down and see. There’s often a large bump where the big toe connects to the arch of the foot, along with sideways deviation of the big toe and sometimes rotation as well. There can be redness and tenderness where the bone and soft tissue are rubbing against the inside of your shoe, and this often results in poor walking and running gait. A bunionette, or tailor’s bunion, is the same process occurring at the pinky toe.
Why should I worry if it doesn’t hurt?
A bunion begins with a bump and some toe crowding. No big deal, right? But it KEEPS GOING. Over time, the other toes get crowded together, begin curling/gripping, and in severe cases the other toes hop over the big toe to “make more room” as you can see in the final photo. These are all responses from the bones and muscles of the foot in an attempt to manage load; your foot is “helping you,” believe it or not!
Also, if your foot is doing all this, what do you think your knees, hips, and back are doing in response? Patients with bunions often come to my office with pain in other areas, and aren’t even aware of the bunion as a source of movement dysfunction upstream. Often times, they have been struggling with knee/hip/back pain for years and no one has ever checked their feet until they see me!
What causes bunions/bunionettes?
First, let’s bust this myth: you do NOT have bunions/bunionettes because your Mom or Grandma have them; rather, they are the result of poor loading due to foot/hip weakness and very commonly, due to toe crowding in modern shoes. This includes your favorite pair of sneakers, it’s NOT just for high heels. Men have bunions too!
Bunions and bunionettes occur when the foot is unstable, and the long metatarsal bone in the arch of the shifts outward. As a result, it forces the big toe or pinky toe to shift inward, and generally progresses over time. This leads to an array of problems, as seen in these photos & x-rays.
The shoe on the left is a common shape for mass-market sneakers and casual wear, and is causing all sorts of havoc compared to the more natural foot-shaped shoe on the right.
We “expect” the woman’s shoe on the left to be squinchy, but notice that even when she puts on a healthier shoe, her toes stay crunkled: that’s why new shoes are just phase 1 of our plan!
What can I do to resolve bunions? (Hint: NOT surgery!)
Come in and get checked. If it is still flexible (can be repositioned), we have an opportunity to intervene and start reversing it! A big part of that is fitting you for toe spacers.
Get educated about and start wearing natural footwear. These are shoes with a wide toe box, zero heel drop, and variable amounts of cushioning. Healthy shoes have come a long way, there’s dozens of amazing online brands to choose from, and I will help guide you along the way, as well as explain what all this new-fangled shoe jargon means.
Get a gait and lower body evaluation. How are you walking, squatting, bending every day? Are you able to balance, go up/down stairs, pick things up from the floor?
Get treated. Chiropractic adjustments will restore motion to your feet, ankles, knees, hips, and spine. Manual therapy to the muscles of the feet/legs/hips is also very important.
Get moving! We will work together on improving your gait, foot and hip mechanics, and addressing movement patterns up the chain at the knee and hip. I want you walking, dancing, and dominating the grandkids on the pickleball court, with feet, knees, and hips that don’t complain about all the fun you’re having!
