Can Footwear Cause Bunions?
July 20, 2015 at 10:11 AM
Hallux Abducto Valgus (HAV), or bunions, are a common condition affecting up to one third of adults. They are characterised by the "bump" on the side of the big toe. This bump can either be boney growth, or a protective bursa (often it's both).
What is a Bunion?
A structural change of the two bones that make up the "big toe joint". Shown on the image to the right, the metatarsal (long bone) has shifted outwards, this makes the phalanges (two short bones in the big toe) shift in towards the other toes. This makes the joint stick out at an "L" angle and creates the typical "bunion" deformity we all recognise. The bursa is a benign cyst that develops to protect the joint from being rubbed by footwear.
Why do I have a bunion?
Studies have shown a high genetic predisposition to HAV formation. If you have a relative with HAV (particularly a parent) your chance of developing one is increased. Approximately 90% of people with HAV have a family history of the deformity.
However, another study showed that footwear may be a major factor. It found that those in shoe-wearing populations were 15 times more likely to suffer from HAV than in populations that don't wear shoes. Perhaps it's because shoes squeeze the toes from the sides, or because they have heels, or perhaps it's because the natural pattern of our gait changes when in shoes. This may mean that we use certain muscles less, allowing for the big toe to start its migration.
There isn't much recent research on footwear causing HAV, but the general consensus has been, for a long time, that footwear has a part in at least accelerating the deformity's development.
Your foot shape, foot posture, and various muscle tightness and weaknesses can also make you more likely to succumb to the HAV deformity. It is interesting to note, that these factors may also be genetic.
So how do we treat bunions?
At FootSense, we have seen great success with our treatment plan. It includes conservatively aligning the big toe, manipulation of the joint, stretching and strengthening of the surrounding muscles, and in some cases orthotics. We very rarely ever have to refer people off for surgery.
Come in to see us about your bunion, it's always best to start a treatment plan in the earlier stages, to slow down the progression of the bunion.
Nix SE, Smith M, Vicenzino B. Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. J Foot Ankle Res. 2010; 3(1): 21.
L.A.M. Sim-Fook, A.R. Hodgson. A comparison of foot forms among the non-shoe and shoe-wearing Chinese population. J Bone Joint Surg Am, 40 (5) (1958), pp. 1058–1062