Avoid Getting Bunions

Bunions are inflamed, sore, and swollen bumps at the joint of the base of the big toe that develop when the big toe is constantly pushed towards the other toes, typically by wearing narrow-toed, ill-fitting and/or high-heel shoes. Flat feet, knock-knee posture, genetics and even arthritis also contribute to bunion formation, which can mimic arthritis because of the inflammation, redness and dull, achy pain involved. As bunions progress, the big toe becomes more crooked and generates more pain, which may lead to limping and other joint problems in the ankle or knee. Bunions are quite common in the United States, with more than 1/3 of women affected. Learning how to avoid getting bunions will ensure healthier toes and feet.

Steps

Wearing Appropriate Shoes

1. Avoid narrow shoes. The vast majority of bunions occur in women who wear shoes that are too narrow for their feet. Narrow shoes crowd the toes and significantly increase your risk of developing bunions. Changing to shoes that have wider toe boxes, better arch support and conform to the shape of your feet can certainly help prevent bunions (if not completely stop their progression), but it won't correct an already established bunion. Think in terms of prevention, not correction.
   • To minimize the risk of getting a bunion, never force your foot into a tight shoe that doesn't fit properly. For examples, most cowboy boots and some swing back sandals are too pointy in the toe for most people.
   • Get fitted for your shoes by a shoe salesperson later in the day because that's when your feet are at their largest, usually due to swelling and slight compression of your arches.
2. Don't wear high heels. Women are often expected or pressured to wear high heels for many jobs and due to fashion trends, but heels more than 2 inches high can force the body to tilt forward, which creates lots of pressure in the feet and toes, as well as strain in the low back. In addition, high heels are almost always far too narrow for most people's toes.
   • Avoid shoes that are short, tight or sharply pointed, and those with heels higher than 2 inches. You should be able to wiggle your toes while your shoes are on.
   • Wearing completely level shoes is not the answer either, because too much pressure is put on the heel, so wear shoes that are elevated in the heel by about 1/4 or 1/2 inch.
   • About 90% of bunions happen to women, mainly due to their poor choices of footwear.
3. Always choose well-fitting shoes. Avoiding the latest trends and choosing shoes tailored to your foot size and shape is a great strategy to help prevent bunions. Go for sturdy shoes with wide, supportive insteps, broad toe boxes and durable soles. Make sure that they grip your heels tightly, provide enough room to wiggle your toes and have enough interior support to prevent pronation (the rolling inward or collapsing of your ankle). Most good quality athletic or walking shoes with wide toe caps are good choices.
   • There should be at least 1/2 inch of space between the tips of your big toes and the end of your shoes while you're standing up.
   • Select shoes with a soft leather upper that will stretch and give naturally with your walking motion. Shoes with good arch support or using arch support insoles can also be helpful to prevent bunions.
   • In addition to ill-fitting shoes, other risk factors for bunions include certain foot types (flat feet, long toes, loose joints), previous foot injuries such as broken toes, and foot deformities present at birth.

Managing Bunions at Home

1. Walk around the house in bare feet. Instead of restricting your feet in shoes, sandals or slippers, spend more time walking barefoot. Walking in bare feet will widen your feet, improve balance and strengthen your toes with time. Walking barefoot makes the big toe work harder while toeing off during normal gait, which forces the tendons and ligaments to get stronger — potentially reducing the risk of bunions.
   • When you first go barefoot, start walking on softer surfaces around the house, such as rug or wood floors with some give or springiness, so as to not create too much force on your feet.
   • As your feet grow accustomed to walking barefoot, progress to harder surfaces both inside and outside your home, but be careful to avoid insect bites and puncture wounds.
2. Use cold therapy. If you notice your toe is swollen and painful after exercise or a day at work, then apply something cold in order to reduce the inflammation. The application of ice is an effective treatment for essentially all minor musculoskeletal injuries, including bunions. Cold therapy should be applied to your toe for 10-15 minutes every 2-3 hours until the pain and swelling subside. Cold therapy should be used in conjunction with changing your shoes to wider, more supportive types.
   • Always wrap ice or frozen gel packs in a thin towel in order to prevent frostbite on your skin.
   • If you don't have any ice or gel packs, then use a frozen bag of veggies from your freezer.
3. Apply a splint. If you notice a big toe is becoming a little crooked, then consider applying a splint for structural support, especially at night while you sleep. Taping a plastic, wooden or metal splint around the affected toe might help reduce the pain and realign the joint, depending on how advanced the bunion is. A bunion splint acts as a holder for the big toe and is positioned in a longitudinal direction over the toe, which results in a corrective force being applied. However, splints are mainly for prevention and are not meant to completely reverse a bunion. You may want to check with your doctor or podiatrist before using a splint. Make sure you use water-resistant medical tape so you can bathe with the splint on. Splints can be found at most medical supply or rehabilitation-type stores.
   • As an economically friendlier alternative, consider making your own splint with Popsicle sticks and duct tape.
   • Rigid splints are usually considered night-time splints because the materials don't flex and cannot bear weight.
   • Silicone or felt pads worn on the feet may also relieve bunion pain, but it depends on the degree of crookedness and joint damage.
4. Maintain a healthy weight. In general, people who are overweight or obese suffer more foot problems such as bunions because of the increased amount of pressure on their feet. Flat feet, fallen arches, severe pronation, and "knock knees" (medically known as genu valgum) are much more common among the obese and are risk factors for bunion formation. As such, do your feet a favor by losing any excess weight. In short, you can lose weight by increasing cardiovascular exercise (such as walking) while decreasing your caloric consumption.
   • Most people who are relatively sedentary only require about 2,000 calories per day to maintain their body processes and have enough energy for mild levels of exercise.
   • Reducing your calorie intake by 500 calories daily will result in about 4 pounds of fat tissue loss per month.

Seeking Preventative Treatments

1. See a podiatrist. A podiatrist is a foot specialist who can properly evaluate your toes and tell you whether you have a bunion or if you're at risk of developing one. A podiatrist can prescribe custom-made shoes or orthotics (shoe inserts) for your feet in order to support your arches, provide shock absorption and reduce the pressure on your big toes. Custom orthotics can be expensive without medical coverage, but off-the-shelf insoles may provide preventative benefit also.
   • You may have to buy shoes a little bigger than you normally would in order to accommodate the orthotics.
   • Some medical doctors, chiropractors and physical therapists also make custom shoe orthotics.
   • Your podiatrist may recommend surgery if your bunions are severe or you don't improve with conservative treatment.
   • Some research indicates that bunions may have a hereditary link, which means you may have a genetic predisposition to developing them.
2. Find a chiropractor or osteopath. Chiropractors and osteopaths are joint specialists who focus on establishing normal motion and function of spinal and peripheral joints, such as those in your feet. Manual joint manipulation (or adjustment) can be used to unjam or reposition toe joints that are slightly misaligned, which usually triggers inflammation and sharp pain, particularly with movement. You can often hear a "popping" sound with a joint adjustment.
   • Although a single adjustment can sometimes completely realign your crooked toe, more than likely it will take 3-5 treatments to notice significant results.
   • A slightly dislocated toe can sometimes be mistaken for a bunion (or vice versa), but your chiropractor or osteopath can tell the difference and treat both appropriately.
3. Consider physical therapy. A physical therapist can show you specific and tailored stretches and strengthening exercises for your toes and feet, and if need be, treat any inflamed joints with electrotherapy such as therapeutic ultrasound. A physical therapist may also tape your toes / feet with medical-grade tape in order to relieve symptoms by providing support for the joints, tendons and ligaments.
   • Physiotherapy is usually required 2-3x per week for 4-8 weeks to positively impact chronic joint problems.
   • Good strengthening exercises for your feet / toes include walking barefoot, standing on your tiptoes for 10-20 seconds at a time, and trying to pick up items from the floor with your toes — such as a thin hand towel or pencil, for examples.

Tips

• Acetaminophen, ibuprofen, and naproxen are all medications that you can take for the pain caused by a bunion. Your doctor may recommend cortisone injections.
• To minimize further inflammation in your toe joints, place moleskin pads or similar products in between your toes to prevent them from rubbing together.
• If a callus forms on your bunion, soak your foot in a warm foot bath with Epsom salts for 15 minutes (to soften it up) before lightly exfoliated it with a pumice stone. It may take 3-5 treatments over the course of a few weeks to completely remove the hardened callus.

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Sources and Citations

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• McConnell Tape Your Knee
• Rehab a Sprained Ankle
• Give a Leg Massage
• Determine Shoe Width
• Use Acupressure Points for Foot Pain
• Treat a Sore Toe
• Get Rid of Foot Odor
• Treat Crepitus in the Knee
• Know if Your Toe Is Broken

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