Causes and Treatment of Bunions – Pt 2

A bunion is a deformation of the first metatarsal joint behind the big toe. It typically involves deviation of the big toe to the center of the foot while the metatarsal joint deviates the opposite direction. Three factors converge together to create a bunion.  You can stop the progression of a bunion and reverse most of the damage in mild to moderate cases.

Bony structure of the foot – Morton’s Foot Structure or Morton’s Toe. The first metatarsal, behind the big toe, is short compared to the second metatarsal, next to it. This can corrected with simple supportive insoles.

Muscular attachments within the foot. When ABductor Hallucis muscle varies above or below the center line, activating this muscle will cause the big toe to extend up, or flex down. The tendency of the aDductor hallucis to pull the toe towards the center line of the foot can be reduced by minimizing taut bands in this muscle.

External rotation at the hip. When the leg is externally rotated, the “toe-off” phase of the normal gait is altered and the big toe is pushed to the center with each step. Tight internal hip rotators can be stretched effective at home with some simple exercises.

Treatment begins with insoles for the bony deformation of Morton’s Foot. Inexpensive posture control insoles will support the first metatarsal bone, reduce pronation and shift weight bearing to a more natural position within the foot.

Next, we treat aDductor hallucis muscle on the sole of the foot. For self-care, we recommend using a golf ball or superball of about 1″ diameter to slowly and deeply compress the aDductor hallucis muscles on the sole of the foot. For office workers this can be done under the desk while working.

We also want to reduce external rotation at the hip by stretching the internal hip rotator muscles. During treatment, we will compress and stretch the internal rotators of the hip. For self-care, the “90/90” series of stretches shown below stretch both the external and internal hip rotators equally. Begin seated on the floor with the knees bent and both feet on the floor.

Next, rotate the legs so that the knees are bent in opposite 90 degree bends.

Deepen the external rotator stretch by hinging forward.

Deepen the internal rotator stretch by turning towards the knee of the back leg and leaning back.

Return to center, switch sides and repeat on the other side.

Finally, we want to reduce inflammation – both from the underlying bunion and the rest of the treatment of the foot. We use acoustic compression with the Well-Wave to treat and reduce inflammation of the first metatarsal joint.

If you are having similar issues, you may find that a session or two to identify  the root causes for your individual case is helpful. Call today to make an appointment!

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2019-07-12T08:43:48-06:00
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