20/11/2019
Let's talk about bunions today - a common problem amongst people. Depending on a case might be pain free or very painful or may progress to pain if left untreated.
⠀
When looking from outside it is a bump on a medial aspect of a foot associated with a big toe being shifted towards other toes.
⠀
❓What is this bump?
⠀
When looking from inside - It is a bone medial deviation, 1st metatarsal bone medially deviates outside the foot and at the same time big toe tilts to the opposite side.
⠀
❓What are risk factors?
⠀
🔹Genetics
🔹Gender. Female are more likely to develop bunions.
🔹Shoes. It was shown that those populations who do not wear shoes do not have bunions.
🔹Joint hyper mobility
🔹Flat feet might be associated with bunions
⠀
Pain associated with bunions varies from total absence to quite severe depending on many factors including degree of deviation, condition of soft tissues, by that I mean not only strength but also how a person engages a particular muscle in a particular movement.
⠀
❓What can be done if you keen to avoid surgery?
⠀
As always, I promote a complex approach addressing an issue from different sides.
From addressing musculoskeletal side, from eliminating aggravating factors, from considering support aids and of course, rehab exercises.
⠀
✅ Let me start from manual therapy first.
⠀
It is a musculoskeletal condition. Bone deviation creates different movement patterns, different muscle engagement, changes tension in muscles.
As a remedial massage therapist, we locate area of dysfunction.
For example, big toe here is constantly adducted. What about a muscle which adducts big toe? Is it tight and short? What about releasing it?
How good it might be for someone's big toe mobility.
⠀
What about calves? Are they tight? Tension in calves might be also associated with bunions.
What about joints? Is foot hyper mobile and then we need to strengthen the muscles of the foot to support hypermobility or hypo mobile and then we have wonderful joint mobilisation techniques under the belt.
⠀
This is to begin with, then аs treatment will be progressing towards healing and new movement pattern will be adopted then massage can hugely support this change .
⠀
✅ Second, and I cannot stress this enough:
it is extremely important what you do outside walls of a treatment room.
I am talking shoes now.
⠀
Here is a visual demonstration what happens with a foot in a shoe.
⠀
So here is my foot in a beautiful but narrow shoe - no space for toes to move.
It actually pushes toes inwards, creating extra stress on the first metaphalangeal joint (MPJ) not to mention high heels.
⠀
What I am saying here does not mean you stop wearing high heels, you may wear heels all your life and go pain free. It happens.
⠀
�✅ Third, Support aids such as k-tape or spacers, for instance.
⠀
Important when wearing spacers:
1. shoes must accommodate toes splayed out in a spacer
2. Important to move when in spacers, for example to train in them,
⠀
✅ And Forth , exercises
⠀
So we are getting back to manual therapy because remedial massage therapist not only does soft tissue treatment but also prescribes rehab exercises.
We want to strengthen particular muscles in a foot in order to , depending on a condition, to activate big toe or maintain medial arch or how to establish connection between muscles in a foot and breathing for example.
⠀
If you do have a problem , bear in mind that it is mostly likely treatable, and YOU CAN DO A LOT TO HELP YOURSELF AND REDUCE PAIN.
⠀
I hope it was helpful.
Tag a friend below who you think might be interested.
⠀
Stay healthy.
