Physical Therapy for Bunion Relief
Bunions are a common foot condition in the typical person and athletic population. The most popular type is a “hallux valgus” deviation. This enlarged bony bump forms at the base of the first metatarsal (Big toe), causing a directional deviation or shift of the big toe towards the other toes. This alignment deviation can cause severe pain and swelling, leading to difficulty with walking, running, and other sports-like movements. This condition is highly prevalent, impacting over 64 million Americans. Its incidence rates vary across age groups, affecting 3.5% of adolescents, 23% of adults aged 18 to 65, and approximately 36% of individuals over 65 years old.
There are many causes of bunions, including genetics, decreased arch support, or osteoarthritis. While ill-fitting shoes are often blamed for causing bunions, it is more accurate to say that the irritation and friction from wearing narrow shoes aggravate the underlying bone, contributing to the condition. Due to its progressive nature, individuals with bunions may experience soreness, burning sensation, redness, and general pain during active and rest periods.
We are constantly on our feet. So, when experiencing pain in that region, it can cause a huge disruption in everyday activities, even more especially in athletics due to the constant loading and forces distributed through the foot during running, jumping, etc. The big toe is responsible for creating an arch, transferring power, and absorbing impact, so when there is some type of disruption, this can cause other compensations within the lower extremity.
There are surgical and non-surgical ways to fix or heal bunions. The surgical route with a primary goal of realignment of the foot involves invasive methods, including inserting screws or pins into bones or shaving the bone Healing times depend on the type of surgical procedure and the person however can take as long as 6 to 12 weeks to return to walking and up to 3 months for running and return to sports. Also to note the possible complications when it comes to any surgical procedures, including possible nerve damage, infection, and even bunion recurrence. While surgery is a viable option, it can cause a huge disruption in everyday life and greatly affect athletic performance.
A non-surgical approach to addressing bunions involves conservative treatment with physical therapy. Physical therapists (PTs) can help in numerous ways, including education on external factors that could be contributing to your pain, including movement mechanics or footwear. PTs can also provide manual techniques to reduce pain, prescribe specific exercises to strengthen the foot and ankle musculature and provide functional training to enhance movement control, encouraging individuals to move their bodies efficiently and safely. Attempting physical therapy initially can delay and potentially avoid the need for surgery. In the case where surgery is required, a physical therapist can work with you during post-surgery rehabilitation for a safe return to everyday and physical activities.
Other nonsurgical options include braces and toe separators, designed to improve alignment and reduce pain. However, research indicates that individuals experience greater improvements in both pain and alignment when these tools are combined with consistent physical therapy treatment, compared to using braces or separators alone. It is important to seek treatment early to prevent worsening complications. Physical therapists are knowledgeable in creating personalized treatment plans that can aid in the recovery of bunions. So, it is encouraged to consult your nearest physical therapist for an evaluation and treatment options.
Written by Kennedy Hardemion, SPT
References:
1. Barnes D, Matijasich P, Maxwell A, et al. From etiology to intervention: a holistic review of bunion pathophysiology and care. Adv Orthop. 2024;2024(1):9910410-.doi:10.1155/2024/9910410
2. Glasoe WM. Treatment of progressive first metatarsophalangeal hallux valgus deformity: a biomechanically based muscle-strengthening approach. J Orthop Sports Phys Ther.2016;46(7):596-605. doi:10.2519/jospt.2016.6704
3. Cleveland Clinic. Bunion surgery (bunionectomy). Cleveland Clinic. June 7, 2023.
4. ChoosePT. Physical therapy guide to bunions (hallux valgus). ChoosePT. https://www.choosept.com/guide/physical-therapy-guide-bunion-hallux-valgus.
5. Boyce M, Dagg A, Dalili M, Doyle C, Nilsen K. Are there effective nonsurgical treatments of bunions?. EBP . 2022; 25 (8): 18-19. doi: 10.1097/EBP.0000000000001625.