What is Bunions?

If you’ve ever been informed you have a bunion, you’re familiar with how they look. Bunions have a distinct appearance that draws attention to them. A bunion is a bony protrusion on the medial side of the first metacarpal joint that is commonly accompanied by hallux valgus. A bunion is a condition in which your big toe bends towards your other toes. It is commonly accompanied by pain on the inside surface of the big toe’s base.

Bunions can range in severity from moderate to severe.  These changes eventually cause discomfort and functional deficits, such as difficulty walking. It is more common in people who have flat feet or hammer toes.

What can be the causes of bunions?

• Gender (10 times more frequent in women)
• Footwear, wearing tight pointed shoes.
• Congenital.
• Chronic Achilles tendon tightness.
• Flat foot.
• Hypermobility of first metatarsocunieform joint.
• Overweight.

What are the signs of bunions?

• Pain in the great toe.
• Tenderness at the base of the great toe.
• Your great toe drifts toward the rest of the toes.
• Bony enlargement at the base of the great toe.

Non-operative treatment

Footwear should be adjusted to assist decrease friction; the patient should be given a shoe with a broader and deeper toe box.

A tailored insole may be beneficial if the bunion is accompanied by the problem of flat feet.

Physiotherapy Treatment:

Pain management with the help of therapeutic modalities such as Combo therapy, Kinesio taping technique, Cro-therapy, soft tissue massage, and dry needling.

ROM can be restored by joint mobilization, muscle and joint stretch, bunion stretch, and soft tissue release.

Foot muscle strengthening exercises such as 

From a seated position, instruct the patient to form a dome with their foot by squeezing the toes down and shortening the foot using isometric holds.

We can progress this exercise by

• Instruct the patient to press the first toe down and lift the other four toes up, then reverse the process, pressing the four toes down and lifting the big toe up.
• Use an exercise band to add some resistance (put the band underneath and press down on it while pulling the band up with both hands).
• Instruct that the patient repeat the exercise while maintaining the dome of the foot. Another phase would be to get the toes down, the first ray down, and then start elevating the heel while maintaining appropriate foot posture.

Once the patient manages to do it well in sitting, progress into these positions: Standing, Standing on one foot, Walking, Step Up, and Step Down.

If the patient’s calf muscle is weak, ask him/her to stand over the edge of a box or a step to push themself up. If their calf muscle is tight then ask them to stand over the edge and drop their heels down.

Stretching or lengthening of the contracted Achilles tendon may be required. Soft tissue release of toe extensor muscles.

The above exercises are just the basic movements we include in a patient’s exercise program. If you want a custom program to follow for your foot/ankle rehab, contact us via email/call/or WhatsApp, or you can also have an online consultation with us for online consultation registration visit our website https://www.elitephysiotherapy.in/