Big Toe Bunions: treatment and myth busting

A bunion on the big toe is a common dysfunction we see as physiotherapists. Sometimes they are painful but other times they just look unusual and patients often ask us why their big toe has slowly changed shape over time.

Firstly, let’s bust the myth that bunions are hereditary. Contrary to popular belief, bunions are not related to genetics. They are not attributed to inheriting poor bone structure and should not be treated with surgery (most of the time!).

In most cases there is an external reason for the production of a bunion, and it is most likely what you are wearing on your feet! So let’s talk about footwear and bunion prevention.

Human feet are naturally widest at the ends of the toes – not at the balls of the feet. Look at the feet of a baby, their toe region is always wider than the rest of the foot. BUT most modern footwear is manufactured to be widest at the balls of the feet, which causes the toes to be pushed inwards. This is why if you look down at your feet now perhaps your toes look squashed inwards and cramped? Your toes are not designed to be that way however footwear has caused this to happen over time. Most commonly the big toe is the one to suffer and can look like the picture below on the right. For our patients who are dancers – have a think about how your pointe shoes may be causing this to happen as well.



So what are some things you can do to manage and prevent bunions forming?

  1. Only wear shoes that are wider at the toe box (and not just the balls of the feet). If you are finding it difficult to locate shoes like this talk to your physio about some options.
  2. Use tape or orthosis to help correct the big toe alignment. My current favourite is the “Correct Toes” orthosis which can help correct alignment, strengthen the foot and restore function.  We can also use K tape or Rocktape to correct the alignment.