WHAT ARE BUNIONS? The dictionary describes a bunion as a deformity of the joint connecting the big toe to the foot. The big toe often bends towards the other toes and the joint becomes red and painful.
No matter what your chief complaint is when you come in to see me, I start all my assessments off with how you’re standing. I will ask you to stand in your normal standing position. Then, I bore you with lots of small talk and questions. Although I am interested in social conversation, I mainly do it because I am trying to see what the effects of time and gravity are on your posture. And sure enough, after a minute or two, the feet start to move out into external rotation, the bum tucks under, and the spine starts to slouch.
The reason for the collapsing posture is that it is the result of our ‘sitting’ lifestyle. Our bodies start to conform to the shape of the chair we sit in!
The feet, being the foundation of our body when we are weight bearing, start to compensate for the lack of the rest of the body in holding itself up. Often the feet, go into external rotation.
Now, the body itself is perfectly designed. Every muscle, joint, bone shape is designed to support weight, propel us most efficiently, and to compensate where we are lacking. But over time, the compensations start to take over and bones and muscles that weren’t designed to hold our weight will start to deform.
One of the first places that start to deform is the joint where the first toe meets the foot, called the first metatarsal. When this deformity takes place here, the long bone of the first toe starts to bend towards the rest of the toes, to give that classic bump on the side of the foot, referred to as a bunion. If shoes are worn and this bump gets big, there’s a lot of rubbing when the foot is in shoes and there’s lots of inflammation and pain. This is usually when people seek help… when they are in pain.
The feet are so important in setting the alignment for the rest of the body. As many of you know, if you have low back pain or other chronic issues, many chiropractors or chiropodists will prescribe orthotics and proper shoes to put the feet in better alignment. However, that is not enough and you may find that orthotics help a little but the pain is still very much prevalent when you do other activities.
In advanced deformity, many seek surgery, called a bunionectomy. Where they break the toe, and pin it. A VERY painful surgery and long recovery.
The good news is, there are many things you can do to prevent a bunion, and in its early stages, even reverse it!
In manual therapy, we do things to mobilize the foot and allow for better movement in the foot itself. But the most important thing is to work on whole-body alignment. If the alignment is off anywhere else in the body, it will impact on where the weight lands in the foot and change the normal movement of the foot and all its joints.
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~ Kathy Leung Degen, Physiotherapist, Osteopathic Manual Practitioner