Tag: bunions

A Movement-Based Approach to Treating Bunions

Yeah, yeah bunions are a trendy topic and I’m cautiously hopping on the bandwagon to offer A perspective influenced by my training with Anatomy in Motion (fully disclosing my biases as an instructor).

Do I have anything new or groundbreaking to add to the bunion discussion? Nope.

Do I have any revolutionary evidence or new theories to prove the causative mechanism for bunion formation? Nope.

Do I really know anything? Not really.

Wish I knew who to credit this to…

In a perfect world, we’d want to understand what factors led to the bunion(s) forming in the first place… Shit footwear? “Genetics”? Repetitive poor movement of the body above? Previous injury? Probably a little bit of everything.

Regardless of the causal factors, it should be empowering to hear that there are some consistent mechanical findings that often go together with a bunion that you can start to address right away.

First, watch this:

As I describe in the above video, a common mechanical consistency with most buniony feet is that the joints posterior to the 1st MTPJ DO NOT GAP on the medial border of the foot and, instead, the big toe joint is doing allllll of the gapping (abduction). A good strategy would be to start to redistribute the gapping of the medial border across ALL joints, not just the one MTPJ.

I think some people call that load-sharing, a term most commonly used in reference to spine motion and can describe why some people have back pain.

Much like a spine with a hinge point at the thoracolumbar junction, through which all their extension is occurring, a foot with a “hinge point” at the 1st MTPJ, through which all their pronation is occurring can lead to a structural distortion over time that can become stiff and rigid and not super comfortable.

The intention of the exercise I demo in the video is to MINIMIZE the valgus/ABduction/ER/gapping (whatever you want to call it) motion of the big toe, and MAXIMIZE joint opening at the other joints on the medial border of your foot, encouraging healthy pronation mechanics with even joint motion distribution through the entire foot.

And if you understand that as a movement principle, you can get really creative with how you go about working with a bunion, or any part of the body.

What about toe spacers?

In the video, I am using the sock-between-the-toes technique in a way that is reminiscent of a toe spacer. But this is not meant to be a passive solution, like toe spacers often are portrayed as. The goal is use the sock as a tool to re-educate your foot to move differently. Not to hold all the toes apart 24/7 in hopes it will change foot mechanics. Like putting a book under your pillow hoping to learn passively in your sleep… I WISH it worked that way.

I’m sure there is a time and a place for toe spacers as a passive tool, but I’ve personally never recommended people to use them, nor have I ever used them myself (nor have I ever told anyone to STOP wearing toe spacers- Your feet, your choice). Except for a few times I painted my toe-nails…

I find the most repulsive thing about this photo to be the choice of polish colour. Bleh.

Here’s another creative set-up one of my clients came up with to redistribute her big toe’s excessive valgus to her forefoot and rearfoot:

The band is pulling her valgus big toe into ADduction (towards midline of the body), while she pronates her foot to encourage opening of the joints on the medial border of her foot without excessive big toe bunionization (that’s totally a word). The black AiM wedge is promoting inversion of her forefoot to further encourage healthy pronation mechanics.

Want to learn more?

If you are a manual therapy or movement practitioner and you’d like to learn more about foot mechanics in gait, I will be teaching an Anatomy in Motion Module 1 seminar on Sept 22-24 2023. If you are in the Greater Toronto Area, come nerd out!

This was a quick overview, not intended to be specific medical advice. If you are looking for help for your own body, it is important to receive individualized guidance for your body’s unique issues. Get a professional you trust to assess your unique needs, or get in touch if you’d like to work together to find movement-based solutions to help your body move and feel better.

Bunion Solutions: A Movement Perspective

Bunions are a hot issue for a lot of people.

Why do they form? What do you do about them? Can you do anything about them? Aren’t they genetic? Do you need to get surgery? What about those toe spacer things and splints?

So many questions!

I’m not claiming to have any conclusive answers (and I think the moment we conclude something is the moment we stop learning anything new).

But what I do know is that bunions can be understood and worked with from a movement perspective. That is, movement of the big toe created the bunion, why could movement not also be at least part of the remedy?

I believe movement is medicine. But too much medicince can be problematic too, can’t it?

Here’s a key thing to know: The movement of the big toe that leads to a bunion forming- toe abduction/valgus- happens at a specific moment in time in the gait cycle. Things get problematic when that movement becomes the only option your foot has and becomes a structural adaptation, ie, the actual shape of your foot changes.

The bunion itself is the solution your body found for a problem.

The video below is a clip from a Movement Deep Dive Session I did recently with some of my amazing Liberated Body students. The session was to help them understand big toe mechanics with foot pronation and supination as we walk.

I think knowledge is power… Wanna geek out?

In the video I cover:

  • What joint motions are possible at the big toe joint (aka 1st metatarsalphalangeal joint aka MTPJ)?
  • How is movement of the foot on the floor- closed chain- different than when it swings through the air- open chain?
  • What does the big toe do when the foot pronates and supinates?
  • What big toe/foot movement creates a bunion over time and when does that happen in gait?
  • How can a bunion be seen as an indicator to that we need to pronate that foot better?
  • How could this be affecting stuff above, like your neck?

When we understanding how the big toe moves in relationship with the foot and the rest of the body, we have powerful information to inform the decisions we make for our bodies everyday.

I hope the video demonstrates how the big toe movement that leads to a bunion forming- toe abduction- is a totally natural event with each step we take. We just want to have other options, too.

Interestingly, while bunions are association with a more pronated foot, the bunion may form because the foot doesn’t pronate well! The big toe abducting away from the foot was the last ditch attempt to do something that resembles pronation. I often find that if we show the foot how to pronate better without relying solely on the big toe deviating into excessive abduction, good things happen.

So if you have a bunion, maybe your big toe is just stuck in a moment in time because it only has one option for movement? What if you could show it a new option?

I think its safe to say that before electing for an invasive buinion procedure, or using a medieval-looking toe stretching devices, or shoving spacers between your toes, why not try some natural movement, first? Give that foot some of its movement potential back.

Best case scenario, you can get that toe moving again and things will feel better. Worst case, you mobilized your feet and got some extra bloodflow. Win win.

This is why I’m so passionate about the work Gary Ward teaches in his Anatomy in Motion courses. What if we could restore the movement potential inherent in our gait cycle, so that each step we take has the ability to reinforce healthy joint mehcanics? Walk ourselves well.

Want to learn more? I think you’ll really enjoy my four day workshop Liberated Body. We spend the whole of day two moving your feet 🙂 I have a live workshop every few months, and it’s also available as a home-study you can start today 🙂

In fact, here’s a story from one of my students, a dancer and yogi, who embraced pronating her feet and was able to free up her bunion:

“My most enjoyable class and the biggest change I noticed was in the FEET! I feel that I have avoided pronation like the plague which stems from ballet training for sure – but my feet, achilles, calves and even knees felt SO GREAT after that class.  I purposefully went for a walk afterwards and could really feel a difference in my foot pressures as I moved.  Also as I mentioned at the end of the session, my bunion on the right side felt released and not as painful – coming up to demi-pointe on that side was a breeze.”

Super cool, right!?

What do you think? Do you have bunions? Have you had a bunion surgery? Have you had success using movement to relieve bunion pain? I’d love to hear from you.

Leave a comment here, shoot me an email, or find me on the social media things you do. I’m pretty much the only Monika Volkmar on the planet, so I’m easy to find 😉