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Medical Etiology: (information for health professionals)
Definition:
A valgus deviation of the hallux commonly associated with an exostosis on the 1st metatarso-phalangeal joint.
Symptoms:
Bunions can sometimes be very painful or in other cases exhibit no pain at all. When irritated by tight or ill-fitting shoes bunions can become red and swollen.
Biomechanical etiology:
Bunions are most commonly caused by forefoot adductus and excess pronation of the Subtalar joint. Some bunions are caused by arthritis or trauma. Interestingly, footwear is not the common cause as generally believed.
Due to excessive pronation, forces load the medial forefoot area. This increases the load on the 1st metatarsal shaft in an adductory direction, causing rotation of the shaft, which then requires the Hallux (big toe) to compensate by abducting. Feet that have short 1st metatarsals or are hypermobile are more
susceptible to this condition.
Treatment:
Orthotics control excess pronation (although not forefoot adductus) thus reducing load on the medial forefoot area and reducing valgus deviation of the hallux. Orthotics re-distribute the weight over the foot which may prevent or reduce gradual growth of a bunion. Sometimes surgery may be indicated.
Exercises:
• Intrinsic forefoot exercises
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