Avoiding Bunions Texas. The physical components of longevity are highly dependent on our feet (Lean Body Mass, Foot Speed, VO2 Max, and Leg Strength). Unfortunately, bunions will occur in a quarter of adults ages 18-60 and one-third of adults ages 65 and older. Approximately 35% of women over the age of 65 will attain this condition if no preventative intervention is done. That is a significant portion of the population! It completely changes our ability to walk or run at normal speed and move with good stability. This ultimately leads to being more unsteady and less mobile over a lifetime.
What Is A Bunion?
Avoiding Bunions Texas. A bunion is the foot deformity above that presents as eversion of the hindfoot (inward rolling of the calcaneus), adduction of the first ray (first ray = the 1st metatarsal and 1st Cuneiform, and abduction of the hallux (big toe) at the first MTP (metatarsophalangeal joint) that occurs because of the following reasons:
- Presence of flat arches, aka pes cavus, aka flat feet.
- Having a tight Achilles tendon (contributed by the gastrocnemius and soleus muscles) causes more overpronation and more loading of the medial forefoot and big toe.
- Consistently wearing tight-fitting shoes with a narrow toe box (space at the front of the shoe), is why bunions occur more in women.
- Having systemic diseases such as rheumatoid arthritis, diabetes mellitus, gout, or even a stroke, any condition that causes neurological damage that does not allow for supporting muscles of the medial forefoot to work normally can lead to a bunion formation
- Congenital conditions which are beyond the scope of our content today.
Avoiding Bunions Texas. Our big toe is significant toward stabilizing our foot to maintain our balance and maximize our mobility. It becomes much harder with a bunion deformity. This foot injury stops you from wanting to move because of the discomfort and pain. Being able to perform active activities that bring you joy becomes more difficult. If you can prevent bunions from forming and worsening, you provide yourself with many options in life.
You can have no physical limitations on vacations, be there fully for loved ones, and be free from concern about trying new active hobbies. We don’t think about this area of our body often. But maybe it’s time to start taking notice.
The Muscles and Exercise to Prevent and Maintain Your Function
Avoiding Bunions Texas. So what can be done proactively? Effective actions can be taken. Your foot is like any other body part and needs the proper respect and care to work well. If you plan on remaining functional to give you the most life options, working on your feet should become part of your normal routine. Here are some guidelines to prevent bunion formations:
Tight calves are a common reason the medial forefoot receives excessive pressure leading to bunions. You can prevent that by doing two stretches:
- Calf (gastrocnemius) Stretch: With one foot forward, and one foot back, both facing the wall, keep the back knee straight with the heel on the ground and turn your hips slightly toward the side of the back foot until you feel the stiffening of the arch of the foot. Bend the front knee to feel the stretch on the upper to mid-calf of the back leg and hold for 60 seconds. Perform each side the day before running and immediately after.
2. Calf (soleus) Stretch: one foot forward, one foot back but slightly closer toward the wall compared to the gastrocnemius stretch, both facing the wall, turn your hips slightly toward the side of the back foot until you feel the stiffening of the arch of the foot. Bend both front and back knees to get the stretch in the mid-calf of the back foot and hold for 60 seconds. Perform each side the day before running and immediately after you run.
Stabilizing your medial arch so it will not collapse will also decrease excessive pressure on the medial forefoot, leading to bunions. You can do this by performing:
3. Tibialis Posterior Trunk Rotation Heel Raises: With your stance foot turned in and the balls of the foot just inside the edge of an elevated step, raise on your lateral toes and bring your opposite swing knee to the stance shoulder while maintaining an upright posture, make sure to feel the muscles of the medial calf working. Pause at the top for a second, and come back down below the horizontal with control on a 4 count. Perform 1x/day, every other day, 1-3 sets of 30 reps each leg.
Avoiding Bunions Texas. The adductor hallucis muscle pulls your big toe laterally and secondarily flexes it down to the ground contributing to bunion formation. Wearing shoes, especially those that are tight in the toe box (forefoot area) can cause the spaces between your metatarsals to get cramped together irritating nerves that feed muscles that stabilize the foot against bunion formation. Keeping that adductor hallucis muscle loose and your metatarsal spaces open can be done by:
4. Tennis Ball Rolls: In sitting, start with the tennis ball on the lateral side of your foot just below the ball of the foot of the 5th digit. Apply pressure by leaning forward and rolling the ball across following the path of the balls of the foot.
When you get to the 1st ball of the foot, maintain the pressure, extend the big toe up towards your shin, keep the other toes down, and roll the ball down the middle of the foot until you reach the heel. Repeat for 3-5 minutes, each side on the days after your run or being on your feet for an extended period.
Avoiding Bunions Texas. Your big toe needs to extend at least 60 degrees for optimized walking, and 80-90 degrees for optimized running. As mentioned before the adductor hallucis pulls the big toe down and out. We can prevent that muscle from getting too tight by performing a stretch on the big toe in the opposite directions:
5. Big Toes Dorsiflexion and Abduction Stretch: Keep your heel and balls of your foot on the ground, stabilize the base of the second toe with your thumb, and bring the big toe up towards you while at the same time provide a slight pull of the big toe medially. Hold at the end range for 30 seconds. Perform 1x/day, 2 sets, each side, daily.
The Abductor Hallucis, Flexor Hallucis Brevis, and the Abductor Digiti Minimi muscles of the foot help to stabilize your foot in stance, support your medial arch, and ensure flexibility for optimal alignment to prevent bunion formation. We can improve the above areas with coordination by performing:
6. Short Foot Toe Spread Out Exercise: Progress from sitting to eventually performing in standing. Keep the heel and balls of your foot on the ground. Forcefully push the balls of your foot down and keep your toes up. When done correctly, the toes are held suspended above the ground. Next, spread your toes while keeping the balls of your foot and heel on the floor.
With your toes spread apart, push the little toe downward and outward into the floor first. Next, spread the big toe wide medially and push it toward the floor while keeping toes 2-4 suspended. Feel the medial arch of your foot contract and hold for 5 seconds. Repeat for 15-30 reps on each side, daily until fatigued.
Avoiding Bunions Texas. The Peroneus Longus muscle of the lateral leg stabilizes your medial arch which is again crucial to not allowing excess pressure to occur to the medial forefoot that leads to bunion formation. You can activate this muscle by:
7. Sitting Peroneus Longus Activation with Band: Bring your feet together and tie a theraband around the balls of both feet making sure it doesn’t bunch. Spread your feet apart and keep both your heels and the first balls of the feet on the ground. Keep your arches solid as you press your big toes into the floor and raise your small toes towards the ceiling. Hold for 5 seconds. Repeat 1 set of 15-30 reps until fatigued.
Avoiding Bunions Texas. This routine hits all the major stabilizers of the medial foot and will maintain your flexibility to avoid excessive stresses leading to bunion formation. Yes, you can incorporate spacers between the toes as an add-on treatment.
Just know spacers only maintain flexibility between the toes but do not improve strength, coordination, and flexibility COMBINED for the foot; which is needed. If you’re like me you won’t skip on bang-for-buck exercise routines. Be good to your feet as they will help you live well providing new experiences and memories throughout your lifetime!
Avoiding Bunions Texas Reference List
Cai, Y., Song, Y., He, M., He, W., Zhong, X., Wen, H., Wei, Q., 2023. Global prevalence and incidence of hallux valgus: a systematic review and meta‐analysis. Journal of Foot and Ankle Research 16, 63.
Glasoe, W.M., 2016. Treatment of Progressive First Metatarsophalangeal Hallux Valgus Deformity: A Biomechanically Based Muscle-Strengthening Approach. Journal of Orthopaedic & Sports Physical Therapy 46, 596–605.
Jung DY, Kim MH, Koh EK, Kwon OY, Cynn HS, Lee WH. A comparison in the muscle activity of the abductor hallucis and the medial longitudinal arch angle during toe curl and short foot exercises. Phys Ther Sport. 2011;12:30-35.
Kim MH, Kwon OY, Kim SH, Jung DY. Comparison of muscle activities of abductor hallucis and adductor hallucis between the short foot and toe-spread-out exercises in subjects with mild hallux valgus. J Back Musculoskelet Rehabil. 2013;26:163-168.
Sánchez-Sanjuan, A., Romero-Morales, C., Alfaro-Santafé, J., Almenar-Arasanz, A. -J., Gómez-Bernal, A., & Pareja-Galeano, H. (2022). Foot Anatomical Structural Variations Increase the Risk of Falls in Older Adults. Applied Sciences, 12(19), 9825.
