Hallux Abducto Valgus (AKA HAV / bunions) is a deformity of the forefoot where the big toe progressively shifts towards the 2nd toe, causing a painful lump on the inside of the big toe joint as well as subsequent dysfunction, arthritic change & proximal problems. Pain and redness are usually the first sign of a bunion, with irritation often exacerbated by shoes, particularly narrow, pointy toed or high heeled shoes.
What is a bunion?
Why do they hurt so much?
The big toe joint has an extremely important role to play in taking and transitioning body weight when we walk and exercise. It is the main joint that allows us to push off when we run, lunge on our back leg and plank. As a bunion grows, the foot becomes wider, the metatarsal arch drops and the forefoot splays. Boney spur growths (called osteophytes) can develop on the medial joint line, as well the top of the joint, blocking range of movement in the joint and creating a 'jamming' pain with movement. In addition, the bunion can create nerve irritation, corn and callous formation, rubbing on the shoe and hammer toe development.
How do I relieve the pain?
Bunions can be tricky to settle down without footwear changes. Wearing soft upper, wider toe box, lower heeled (10-30mm) shoes is important to take pressure off the joint and allow the inflammation to settle. If there is a significant loss of joint range, a stiffer soled shoe is recommended. Modifying activity that exacerbates pain is also important. Minimising stair climbs, lunges, burpees and planking is often advised. Hoka One One shoes are best for running and walking.
What else can I do to avoid surgery?
By adding arch support into the shoe, the weight is transferred off the big toe joint and relocated into the arch of the foot. Concurrently, the long bone that attaches to the joint (the1st metatarsal) is realigned and mid foot collapse is prevented. Metatarsal arch support is also important to reestablish the metatarsal parabola and prevent forefoot collapse, splay and secondary deformity such as hammer toes.
The simple answer? The Emily Braidwood footbeds are made with anatomically-designed medial and metatarsal arch support to prevent and alleviate bunion pain, as well as secondary dysfunction.
In addition, using a toe seperator can prevent the big toe from shifting towards the 2nd toe. If pain persists, ensure to see your health professional for imaging and tailored management.