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A Bunion is a condition that affects the big toe joint that can be painful or, in some cases, asymptomatic. Unfortunately, some people are born with bunions, and they should focus on reducing the speed of them progressively worsening. In contrast, those without a bunion or with early signs of bunion formation can follow these 3 simple steps to prevent bunions or prevent bunions from getting worse.
Footwear is one of the most influential factors in preventing a bunion. High heels completely distort the natural gait cycle, placing excess force on the forefoot and holding the big toe joint in an extended position. Holding the big toe extended causes a slight rotation on the push-off phase of walking, leading to bunion formation and cartilage change within the big toe joint, so please only wear them occasionally, if at all.
Regarding the gait cycle, 60-70% of your body weight should go through your big toe when walking. A person wearing an unsupported shoe with poor foot mechanics can facilitate excess pronation moments through the gait cycle. When this occurs, the bone before the big toe gets raised, and the big toe can’t lift over it in the push-off phase of walking. A rotation on the big toe occurs and slowly causes a bunion over time, but this formation can accelerate if the same movement occurs when running due to the increased speed and force of the activity.
1: Have a gait or running gait analysis with a professional. A Sports Physical Therapist or Podiatrist is in the best position to analyse your gait and provide feedback on your natural movement patterns. If this isn’t a viable option, most running stores have a treadmill and staff with some training to help you.
2: The length of your foot can change over time, especially as we get older, muscles become weaker, and ligaments stretch, so make sure you have a correct reading of your foot length, which most shoe stores can provide. Considering this information, unfortunately, some brands have different shoe lengths. An example of this may be an Asics tends to be a long narrow running trainer, whereas a New Balance tends to be a wide fit, so they both might say they are a size 11, but in fact, they may be different lengths.
Shoe length is essential; if your shoes are too short, they can compress the toes, preventing big toe extension and causing a bunion.
3: Shoe width is one of the most overlooked aspects when purchasing a new shoe. The shoe width varies from A-EEEE, and while everyone knows their shoe length, not many know their shoe width. This is vital, as compression in the toe box can cause bunions and, significantly worse, a current bunion.
To learn your shoe width, you can measure it with a measuring tape around the forefoot or most good shoe shops will be able to do this for you. Each band has a set shoe width, while some have varying width sizes to choose from, especially in brands like Hoka.
4: The final thing to consider is your shoe’s toe box’s flexibility. This is vital to preventing a bunion as a flexible toe box allows true extension through the big toe joint. In casual shoes and trainers with a very thick sole, the toe box is exceptionally stiff, preventing the extension of the big toe. A stiff sole in a running trainer with a rocker sole is different as the rocker sole promotes extension of the big toe.
The Flexor Hallucis Longus muscle is one of the main muscles that attach to your big toe and often gets forgotten about in bunion formation. It is positioned on the underside of your foot, and its purpose is to flex (bend) the big toe. However, if it gets tight, it can reduce big toe extension and cause a rotation of the big toe on push-off. This rotation is referred to as a Functional Hallux Limitus and leads to bunion formation.
A critical step to preventing bunions is ensuring Flexor Hallucis Longus is flexible. An easy solution is a stretch with a rolled-up towel.
Maintaining strength and stability in your foot helps to control the pronation moments in your gait cycle. Pronation is a normal movement of the gait cycle, but if it occurs excessively or rapidly with poor control, it can lead to bunion formation. Footwear plays a role in controlling pronation moments, but you can also strengthen your foot and ankle to improve your control.
There are two of our favourite exercises that we recommend to our patients to help control pronation and prevent bunions.