Bunion Pain & What to Do?

A bunion (also known as Hallux Valgus) is one of the most common foot conditions. It is a deformity of the foot where the bones of the big toe shift out of alignment. This is caused by the big toe pushing against the smaller toes forcing the big joint to push outwards.  Smaller bunions can develop on the little toe, this is called a Bunionette. Muscle imbalance in abductor and adductor muscles was cited as a major factor in the evolution of bunions.

What are the symptoms?

• Bulging bump on the knuckle of the big toe 
• Swelling and inflammation
• Pain when walking
• Not being able to wear certain shoes
• Corns and/or calluses around the misaligned joints
• Reduced movement in big toe

What causes bunions?

The exact cause of bunions is generally unknown, but contributing factors are:

• Joint conditions such as osteoarthritis or rheumatoid arthritis
• Previous injuries sustained
• Birth defects
• Family history / genetics
• Being overweight

It is an ongoing argument on whether poor fitting shoes cause bunions or are just a contributor to the condition.

Women are more susceptible to this condition than men. As stated before, poor fitting shoes could be a factor, but also during pregnancy and menopause where there is a higher risk of bunions forming or getting worse. 

Can massage help?

If you’ve had a bunion for some time, chances are you have adapted your walking patterns to help you avoid pain or discomfort. If this is the case you are likely to have developed some over and under use of particular muscles in your legs and potentially caused some unbalance through your hips. In these circumstances deep tissue massage can definitely provide some relief, assist in correcting the unbalances and halt further issues developing.

Can you get rid of them?

An assessment by your healthcare provider is the first step to see what path you would need to take.  Surgery may be considered if the condition is severe. If it is mild to moderate, there are various options to help reduce the symptoms;

• anti-inflammatories to reduce the swelling and pain
• wearing shoes that have a wider toe box
• using toe spacers or splints to position your toes correctly
• maintaining a healthy weight – being overweight can put a huge amount of pressure on your feet and toes. 

Foot exercises and toe stretches for bunions can help keep the joint between your big toe and the rest of your foot mobile, maintaining flexibility and strengthening the muscles that control your big toe.  Below are some examples:

Toe Abduction Exercise 

This exercise is useful for improving mobility of your toes. It is a fairly difficult exercise, and the outer toes may not move much at all. It may take some practice, so keep persisting to aid in reducing the onset of bunions.

1. Place your foot flat on the floor.
2. Try to spread all your toes outwards. 
3. Repeat 10 times.

Big Toe Strengthening

This is to help strengthen your big toe

1. In a seated position with legs outstretched
2. Wrap a resistance band around the big toe
3. Flex your big toe against the resistance of the band
4. Return to your starting position
5. Repeat 5 times

Towel Gripping

This is to help strengthen all your toes 

1. Lay a towel on the floor
2. Place your heel in line with the back edge of the towel
3. Ensure the entire sole of foot is contacting the towel
4. Using a scrunching action with the toes, draw the towel in towards your heel
5. Repeat 5 times

Arch Strengthening

This exercise will strengthen the muscle that moves your big toe from side to side and keep the arch stable. 

1. Feet placed on the floor, making sure they are relaxed 
2. Move your big toe away from the others with your hand, keeping the muscles relaxed and your foot flat on the floor 
3. Keep the big toe in this position by tensing the muscles and pushing the inside and outside edge of your toe/foot into the floor
4. Hold this for 20 seconds 
5. Repeat 10 times 

Ball Roll

This is to release the tension in the underside of your foot

1. Place a tennis or lacrosse ball on the floor and put your foot on top 
2. Roll your foot back and forth over the ball 

Repeat this motion for 3 to 5 minutes on each foot, even if the bunion is only on one foot

Walking Along the Beach

Whenever possible, spend time walking on sand. This can give you a gentle foot massage and also help strengthen your toes. This is especially beneficial for people who have arthritis associated with their bunions

Bunions & Stability

If you have a bunion this can also negatively affect your balance, as the big toe is a big factor in this action. So it is important to work on stabilising the foot. Try standing on one leg and see how long you can do this for. If you find you cannot stand for at least 10 seconds* without wobbling it is important to build your strength.  Check out these exercises;

Foot Stability

To start improving foot stability, try to isolate the big toe from the other toes when you are standing. 

1. Push the big toe into the ground while slightly elevating the other four toes. 
2. Then try to extend the big toe while the other toes remain on the ground.
3. Then, use your finger to apply resistance to the big toe as you try to drive it into the ground. 
4. Hold each action for 20 seconds

Single Leg Balance

Once you can do the above exercises, stand on one leg and see how long you can stand for

Practice this regularly to improve your time each go.

1. In bare feet, standing then take the unaffected foot off the floor
2. Fix your eyes on a point on the wall
3. Maintain this position for the desired amount of time

Do this while you are cleaning your teeth – it’s an easy way to get it into your daily routine

When you are comfortable doing this, try it with your eyes closed. Closing your eyes takes away visual feedback and makes your body work harder to sense the feedback from your feet and make appropriate changes to keep you balanced.  This is called proprioception, your body knowing where you are in space without any feedback, it can often diminish with age, but that’s another blog post!

Add a selection of these exercises to your morning routine, when you’re sitting on the bus or even when cleaning your teeth and you’ll feel the difference in your foot pain, strength and balance.

If you are still struggling with pain see your GP for next steps and if you are looking for some relief for the compensatory patterns you have developed come and see one of our Remedial Deep Tissue Therapists for an assessment and treatment.