Bunions can be a real mystery but I’m hoping that this mini guide will help shed some light on the issue. In my 20s, after repeated foot injuries from skateboarding I began to develop a bunion on my left foot and it wasn’t until I began practicing Hellerwork Structural Integration that I developed some insight into this common misalignment and began correcting the imbalance in my own feet. I am 46 now and haven’t had any issue with pain in my big toe for some time. I won’t lie, it requires a major shift in awareness of the feet to create a long term shift. At first this can seem onerous, maybe even impossible. How can I constantly be thinking about my feet? Well you don’t have to, you only have to be committed to shifting your awareness little by little for patterns to change. Old dogs can learn new tricks and like any new pattern, it can eventually become second nature.. If you have bunions I hope this helps you to manage or even correct your foot misalignments so they don’t stop you from doing what you love.
A Little Background
With bunions, often the stability in the foot is coming from the heel/arch area (supination), while the forefoot is pronating, or the whole foot is pronating. Either way, because of tension in the calves and lack of contact with the ground in the pinky toe ball and big toe ball, the forefoot will tend to wander side to side right before you push off the balls of the foot. What this looks like is a heel strike that either gets unstable transitioning to the forefoot, or collapses in towards the ball of the foot as the arch collapses. The majority of the contact in the front of the foot will be in the middle three toes with the pinky toe and big toe more lifted, so the front of the foot rocks side to side like a boat, or just collapses in towards the ball of the foot. When you look down at your feet, this might not makes sense if you see that your weight is over the outside of your foot, but this collapse inward becomes more pronounced in the terminal stance of the gait cycle, or when your leg is lengthening behind you and you are starting to push off. Long story short, the key to correcting bunions without surgery is to create stability in the front of the foot and to develop a strong arch while stretching the calves (among other things), especially in the terminal stance.
So how do we create more stability in the front of the foot? We can move in the right direction by changing the alignment when doing any exercises involving the legs, stretch the restricted musculature and build awareness of how we are walking. In a nutshell, this means shifting the groins and waistline back when you are walking or standing, stretching the calves, and doing heel lifts and knee bends with the forefoot with good alignment to build awareness of how your foot is tracking as you move. In this article we are going to mostly focus on the feet, but don’t fool yourself into thinking that this issue is just in your feet! Addressing misalignments in the hips and even the ribcage, and developing core support are also extremely helpful for improving or even correcting bunions.
Here is a simplified brake down of how to improve the alignment in your foot if you have bunions.
Exercises
Bunions are also a reflection of a pattern happening in the legs and pelvis as a whole. If we just focus on hip openers and calf stretches with the knee and ankle tracking straint, we can make a lot of progress towards correcting the imbalance. If you are doing standing stretches for your hips and calves make sure to follow the instruction in the alignment video for your feet at the same time. Balanced alignment in the feet is key.
Check out this video for some exercises to create stability in the forefoot.
Massaging Your Feet
Any massage for your feet is probably going to be helpful, but there are some specific areas that are especially helpful with a bunion issue. There are some other one’s we won’t discuss here that can be helpful for different feet but these are universally helpful.
Check out this video for some myofascial release tips to help stretch some of the musculature and fascia that create a bunion. This is some of the work I do in my practice and it can be extremely helpful. Keep in mind that the goal is to build awareness so that you can release these tissues without having to work on them all the time. As you are digging into your foot try to bring your awareness to that part of your foot and focus on visualizing the tissue releasing. This will build the connection from your nervous system to parts of your foot that may be gripping without your awareness.
Shoes
For many people footwear plays a major factor in bunion formation by pinching in the toes and forefoot in. It probably goes without saying that it is extremely difficult to correct bunions if you are squeezing your toes into tight shoes. Any footwear with a wide toe box would help, but some shoes I recommend are:
Lems
Vivo Barefoot
Vibram Five Fingers
Xero
Altra
Some of these brands have models with a slight heel lift. While this is not ideal long term, if your calves are especially tight, you may find that it’s easier to keep your pinky toe ball and big toe ball in contact with the ground through the terminal stance if your calves are not overstretched. A little bit of heel lift can help with that, but it is not a long term solution. Stretch your calves!
Again, the most important thing is a wide toe box and a lower heel. Beyond that, comfort should be your guide and there are lots of other options for shoes with space for your toes if you don’t like the ones I’ve listed here.
Toe Spreaders
Some of my clients have found relief with various silicone toe spreaders. Toe spreaders can be extremely helpful both as a gentle way to stretch the foot and also while doing foot exercises or yoga because they hold the toes in alignment with the metatarsals (next bone up from the toes). Wearing them in shoes is possible for some, but you will need to find shoes with a wide toe box to accommodate the spreader and your widened toes. Wear them for a short period of time around the house at first to avoid straining your feet. I personally find them difficult to wear in shoes or for long periods of time because they cut off the circulation to my feet. Be mindful of this if you are wearing them in shoes. If your toes start to go numb, take them off. If they don’t fit in shoes, you might also try a single toe spacer for the big toe. These are often available at pharmacies, but again it is still important to have a wider toe box in your shoes.
Sugar Toes/Diet:
This is really just food for thought, but you might find it helpful.. I am not an acupuncturist but having collaborated with several acupuncturists in my practice, sharing clients over the years, I am constantly fascinated by how the organs effect structure. I’ve noticed in my own practice that when I do visceral manipulation with a client the musculature around the organ’s meridian often shifts in some positive way. Back to bunions… in Japanese acupuncture bunions are described as "sugar toes". This would make more sense if you know that in acupuncture the spleen and pancreas are related. The spleen meridian runs along the inside of the foot out to the big toe and is generally the part of the foot that is over stretched and weak with bunions. Some things that may help to tonify the spleen meridian, and indirectly support the abductor hallucis muscle that straiten the big toe are:
-Eliminate or lessen sugar, alcohol, smoking, and excessive caffeine.
-Take natural anti inflamatories. Spleen "Dampness" in Chinese medicine can be thought of as a phlegm reaction to inflammation, so a diet that lowers your inflammation can be helpful. If you are having problems with mucus in your throat or sinuses, you might try taking black pepper and turmeric to help with gut inflammation that may be causing the mucus.
-Exercise or anything that makes you build a light sweat like running or jumping on a trampoline, or jumping rope are supportive for the lymph. The muscle that straitens the big toe runs along your midline, so exercises like pilates that promote length while engaging your midline can be helpful as well.
Finding your center. The spleen meridian is all about the pregnant pause of Indian Summer. In each moment that can be likened to being present in transition. Anything that allows you to get present and grounded may be helpful.
Surgery
Obviously there are more than one cause for bunions, and I have only described what I see in my practice. These suggestions may not work for you but they have been incredibly helpful for many of my clients. If your condition progresses to the point of pain that is not relieved by any of the these suggestions, surgery may be an option. In my practice I mostly see the negative results of bunion surgery so I generally don’t recommend it as a first course of action. Surgery is never a quick fix. As with most surgeries you can expect a minimum of 6 months for recovery and you may not get the outcome you were hoping for. If you don’t have any luck with these exercises you might want to speak to an orthopedic surgeon who specializes in working with feet. This is the what the American Academy of Orthopedic Surgeons has to say about bunions: https://orthoinfo.aaos.org/en/treatment/bunion-surgery/
Summary
For many who suffer from bunions it can be corrected without surgery, so don’t give up hope if you are struggling with this. Feel free to contact me if you think I might be able to help you with your own foot dilemmas. I hope this helps!
In Health,
David