My Toes are Crooked – Part 2: BunionsCrooked toes are not just a cosmetic concern. They can be painful and contribute to problems in the foot and ankle caused by an altered gait.
Bunions are the bane of many women and men due to the pain they cause and the difficulty they create in finding comfortable shoes.
What is a Bunion?The medical term for bunion is
Hallux Valgus. Hallux is the term for toe and Valgus refers to the angulation of the first metatarsal bone in your forefoot. In the classic
bunion, the end of the first metatarsal angles away from the foot causing the big toe to angle in.
The external appearance of a
bunion is a large bump on the side of the big toe with the toe angled towards the second toe. Sometimes the big toe will actually sit on top of or under the second toe.
What causes a bunion?There are three answers to this question. The first is the easiest: they can be inherited. If your mother or father has
bunions, you may as well blame it on them.
The second answer is “shoes”. Any shoe can contribute to the formation of a bunion but pointy toed high heels are the worst culprit. The less room in the toe box - the part of the shoe where your toes rest - the more pressure there is on your foot and the more that pressure is likely to cause toes to shift. Add a high narrow heel that forces the majority of your weight onto the ball of your foot and the natural mechanics of the foot are dramatically altered for the worse.
There is a reason there is a “back to barefoot” movement with products such as the fivefinger shoes from Vibram (shown below) and other similar style shoes. They purportedly allow you to walk “as nature intended”. Compared to how one walks in high heels with pressure very narrowly concentrated on the heel and the ball of the foot, there may well be something to this trend. There are of course many choices between the two extremes shown below that answer the demands of fashion without sacrificing the health of your feet. High heels do not have to be “High Hells” to allow you to look good and avoid pain and deformity.
To be fair to the fashion and footwear industries, if shoes were the only cause of
bunions, anyone who has ever worn high heels or narrow toed shoes would have
bunions. Certainly the more you wear “fashionable” shoes, the more likely you are to see the changes in your feet that lead to bunions. Shoes may or may not cause bunions but they do exacerbate problems that exist due to heredity.
Finally, the third answer is that sometimes there is no single cause and it may be a combination of factors including shoe style, heredity, injury or arthritis.
Can a bunion cause problems?Any change in the structure of the foot that alters how pressure is distributed when walking will cause a problem. How severe the problem is depends on how severe the condition is.
Bunions can certainly be painful. Not only does the shifted joint rub against shoes, the soft tissue capsule and ligaments around the joint are stretched and contribute to pain in the toe and foot.
As was noted in a previous blog post
“My Toes are Crooked - Part 1”, the normal balance of the foot means that your big toe should take anywhere from 40%-60% of the force during the “push off” phase of gait. This phase of gait occurs just as the toes of one foot are pushing off the ground and before the other foot hits the ground.
It has also been estimated that the big toe bears a force as great as two times your body weight with each step. If your big toe is angled out to the side and has lost range of motion, it cannot absorb this force nor can it properly propel you forward when you walk.
If you would like to know how bunions are treated check back for the next blog entry or simply sign up for e-mail notification in the left side bar so you don’t miss out on another informative blog.
To read in more detail about the effects wearing high heels can have not only on the foot, but the knees, hips and back read
“Wearing High Heels – Effects on the Body”.You may also be interested in the following blog posts:My Toes are Crooked – Part 1: Morton’s Toe My Toes are Crooked – Part 3: Hammer Toes (coming soon)
Author: Julie Belkin