If you look down at your feet after a long run and notice a red, painful, angular bump forming on the inside of your foot, chances are you have a bunion.
They’re particularly problematic for runners, since every time your foot hits the ground, it absorbs an impact force of up to three times your body weight in a tenth of a second. Also your foot has a lot to do when running. It has to absorb the contact force as you hit the ground, stabilise your body as you move over your planted foot and then provide the base as you push yourself forward against the ground. This all happens in about .25 sec for slow running, for faster running this can be less than 0.1 sec. Our big toe joints play a major role in this process. So if we have a bunion and the alignment is not optimal or the toe does not bend as well as it should then this process described above will not be working as efficiently as possible. Problems can occur with the bunion itself, other foot structures or they may be affecting the way we run and this can the lead to problems elsewhere in our bodies. They may also be impacting on how efficient we are at running without leading to any painful symptoms.
Perhaps the most famous runner to suffer from bunions is Paula Radcliffe who underwent bunion surgery in 2009 with a podiatric surgeon. “"When I sat down with the podiatrist and looked at my injury history prior to the surgery, we realized that every injury, bar one, since 2004 had been caused directly or indirectly by the bunion. My style of running had changed to accommodate it which in turn affected my gait and put additional strain on my body”.
In the short term, bunions can be managed or accommodated well with customised orthotics, steroid injections, and wider shoes but the only definitive solution for adults is surgery to correct the bone deformity. Often people will try to manage without surgery. Orthoses can help to improve big toe function, injections can help reduce pain, looking at the way you run and changing this can also have an impact. If all this does not make a dramatic difference or problems keep on returning – and they may not be problems in the feet, as Paula Radcliffe explained - then it is worth considering a surgical opinion.
Typically, surgery aims to restore both the structural position of the metatarsal and the function of the big toe joint. This has the effect of ensuring that the tendons under the foot are able to work correctly, the foot is more stable during the stance phase and into the push off phase of gait.
There are over 100 procedures designed to treat bunions many of which you may have googled already. In truth the only way to know what procedure is best for you is with a face to face consultation with a trusted podiatrist who has a lot of experience working with runners. It is important that both the structural alignment and function are restored after surgery. As a runner you need your big toe to working as well as it can because poor function at this joint will lead to other compensations which may ultimately lead to painful symptoms.
At Holywell Healthcare we are a team of people who can help you.
Mr Colin Papworth- Specialist MSK Podiatrist
Mr Antony Wilkinson - Consultant Podiatric Surgeon
Mr Tommy Chan - Specialist Registrar in Podiatric Surgery
Mr Scott Hendrick - Trainee Podiatric Surgeon
Mrs Anna Evans - Staff Podiatrist
Call 01246 273848 or email firstname.lastname@example.org