Injury prevention and recovery

Bunions

What is it?

A bunion is a bony lump that develops at the joint around the base of the big toe. It happens when the bone in your big toe (the first metatarsal) starts to push out of the side of your foot at the base of your toe. This is called hallux valgus. It forces your big toe to angle towards your other toes.

A bunion can be painful and make walking and running uncomfortable. The problem tends to get worse if it isn't corrected with surgery.

Symptoms

If you have a bunion, you may have:

  • pain or discomfort in your big toe joint
  • swelling of your big toe joint
  • difficulty walking and running
  • difficulty finding shoes that fit
  • pain under the ball of your foot (as your other toes have to take more of your body weight as you walk or run)
  • red, blistered or infected skin over the bunion
Bunions
 

If you have any of these symptoms, you should see your GP.

Causes

The exact reasons why some people develop bunions isn't known at present. However, some people are more prone to them than others.

Runners may be especially prone to bunions because of the repeated pressure on the big toe joint that occurs during running. If you are an overpronator (your foot tends to roll inwards when you step), you may be at even greater risk of getting a bunion, as you put even more pressure on this joint when you run.

A number of other factors can also increase your risk of getting a bunion, including if you:

  • wear narrow or high-heeled shoes – this puts extra strain on the bones and muscles in your foot, pushing your toes together
  • have a family history of bunions
  • are a woman

Treatment

The following measures can help to ease symptoms of a bunion:

  • properly fitting shoes, including running shoes
  • orthotics (special insoles worn in your shoes) – you can get these from a podiatrist
  • bunion pads, to reduce pressure of your shoes – these can be bought from most chemists
  • over-the-counter painkillers such as paracetamol or ibuprofen (always read the patient information leaflet that comes with your medicine)
  • using a cold compress, such as ice or a bag of frozen peas, wrapped in a towel, until the swelling goes down can be helpful (always wrap ice in a towel or cloth before applying, otherwise it may damage your skin)

However, if you have severe pain or discomfort from a bunion, you may need an operation to correct it. The aim of the operation is to straighten out your big toe joint as much as possible, and reduce pain and discomfort.

Do

  • Get advice from a podiatrist or sports physiotherapist on suitable running shoes.
  • Ask your podiatrist to recommend exercises and orthotics to help relieve your symptoms and slow the progression of your bunion.
  • Seek treatment if you overpronate, this may help to prevent you developing a bunion in the future.

Don't

  • Wear shoes that are too tight – you should be able to wiggle your toes a little and there should be 1cm between your longest toe and the end of the shoe.
  • Carry on running if your bunion is causing you pain or discomfort – make an appointment to see your GP or seek advice from a sports medicine doctor.

Peer reviewed by Ann–Marie O'Connor, Bupa Sports Medicine podiatrist

Publication date: June 2009

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