A bunion is a dislocation of the first metatarsophalangeal—or big toe—joint that occurs primarily in shod (shoe wearing) populations. The American College of Foot & Ankle Orthopedics & Medicine (ACFAOM) suggests that improper footwear may be a cause of bunions in runners.
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The American Podiatric Medical Association (APMA) states that a bunion is a lump of bony and soft tissue situated at the base of the big toe. A bunion develops from a condition called “hallux valgus,” which is a chronic deviation of the big toe toward the foot’s midline. Over time, with this sustained deviation, the base of the big toe becomes inflamed and a prominent bump develops.
According to the ACFAOM, potential causes of bunions include foot function abnormalities, improper footwear, occupational hazards, inflammatory joint diseases, genetic factors and a discrepancy in lower-extremity limb length. The ACFAOM suggests that runners are most susceptible to bunion formation as a result of wearing improper footwear, that is, footwear that’s too narrow, especially in the toe box where toes can be compressed.
Sports podiatrist Dr. Ray McClanahan educates his patients about the pitfalls of conventional footwear, especially about the harmful effects of tapering toe boxes found in most running shoe models. He has identified contributing factors to bunion deformity in conventional footwear as well.
Because of the increased forces acting on the foot, and because of the repetitive nature of the activity and the friction involved, runners are more likely to experience pain or discomfort from their bunions. Fortunately, there are a number of conservative care options available for the runner who wishes to avoid surgery and prevent future foot problems.
Dr. McClanahan states that patients with bunion deformities respond favorably to conservative treatment methods, which include the use of a toe spacer to reposition all the toes—not just the big toe—into their natural anatomical positions. McClanahan suggests introducing range-of-motion exercises to manipulate the big toe into an adducted position (the opposite direction of the way it’s deviating) and selecting shoes with a toe box wide enough to accommodate the toe spacer or bunion splint.