Biomechanics of bunion formation

It’s estimated that 23 percent of all people between the ages of 18 and 65 and 36 percent of those older than 65 have bunions, known clinically as hallux valgus.

Simply put, a bunion is a bony bump that forms on the joint at the base of your big toe and occurs when some of the bones in the front part of your foot move out of place. It is often painful.

Paul Betschart, DPM, is an expert at helping those suffering from this all-to-common condition. A bunion forms, he explains, when the metatarsal instead of moving generally upward, moves out away from the rest of the foot and sticks out on the side. It’s a mechanical issue that destabilizes that big toe bone complex and allows the first metatarsal bone to get out of alignment.

Bunions can be caused by tight shoes, foot stress, arthritis, and family history. Individuals who put more demand on the big toe joint (technically called the first metatarsal-phalangeal joint)will experience this painful deformity earlier. And women who wear high heels will also be impacted earlier.

Dr. Betschart recommends a custom orthotic, and notes that although you can’t correct it completely, you can slow down the progression of a bunion deformity by stabilizing the foot with a properly constructed foot orthotic.

“We treat the symptoms with physical therapy, laser, anti-inflammatory medications, and surgical management if necessary,” he says. “It’s a progressive condition and it can be repaired surgically.”