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Bunions: Is surgery my only option?

Often times we see clients for their ankle, knee or hip pain and coincidentally find their bunions upon physical examination. Most patients that have bunions or toe pain, do NOT want us to take a look at their feet. I am sure the fear of someone touching their already painful and sensitive feet is extremely unappealing. But as is the nature of physical therapists, we are relentless with examining all possible sources of pain. Trust me, we have zero interest in sending you to an orthopedic surgeon for bunion surgery. It is one of the worst surgeries, with painful recoveries which often leads to pain elsewhere.


While it's a common belief that bunions are directly caused by footwear, this isn't entirely true. Bunions occur at similar rates in non-shoe-wearing cultures, although discomfort may not be reported until arthritis sets in.


However, certain footwear like high heels, pointed or tight shoes, ballet and ski boots, and cowboy boots can hasten bunion development. Additionally, factors like low arches, flat feet, or hyper-mobile joints can increase bunion risk, regardless of shoe use.


Alternative Treatment


Let's take a moment to consider an alternative treatment consistent of trigger point dry needling, corrective exercises, and toe spacers. Followed by gait training and balance training, you really can escape the dubious bunionectomy.


The adductor hallucis muscle, when tight and constricted, can cause the big toe to be persistently drawn towards the second toe, independent of muscle contraction. This often happens in people who excessively pronate or walk with their feet turned outwards, which includes many runners and dancers.


The adductor hallucis, with its distinctive "number seven" shape, extends from several lateral toes to the big toe. Its contraction draws the big toe closer to the second toe, influencing the development of the bunion.



The development of a bunion sets off a chain reaction of biomechanical issues. As the 1st metatarsal bone behind the big toe shifts outwards, the foot's inner arch becomes unstable and starts to collapse. This reduced arch support increases stress at the bunion's developing site, which in turn exacerbates the instability of the foot's arch. Addressing this problem requires focusing on both the instability of the foot and the altered joint angle.



Strengthen your Intrinsic Foot Core

Check out Kara's Strengthening Program to build up your arch and strengthen your intrinsic foot muscles to prevent the bunion from returning once you have treated.


Save yourself a very painful surgery, recovery and limited mobility post-operatively that will ultimately lead to compensations in the way you walk which will cause other issues up and down the chain.

Schedule with Cape Concierge Physical Therapy to benefit from this alternative approach.




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