Bunions – Are they just an old lady’s problem? What do they mean for foot structure?

First I saw a bunion as a little girl on my great aunt’s big toe joint. At the time, as I stared at her feet, I didn’t really understand what it was. To me, the bump looked more like half a ping-pong ball hidden under her sock. But back then, it seemed natural that elderly ladies had all sorts of aches and ailments, like a bump at the base of their toe.

Now, to my horror, as a middle-aged person still in my active years, after a few years of vague and occasional pain, I suspect my foot troubles are also caused by a bunion: a bump that has gradually become more pronounced at the base of my big toe. So, does this mean I’ve reached "granny age" prematurely, or what’s really going on here? I’d like to restore the functionality of my feet, but under no circumstances do I want surgical treatment for this condition.

What Is a Bunion?

A bunion forms when structural changes occur in the joint at the base of the big toe, causing the joint and the surrounding bursa to become inflamed and painful. At the same time, the big toe shifts toward the other toes. This altered foot structure can lead to the development of blisters and pain, not only in the foot but also extending to the ankle and even the lower leg.

A bunion is far from being a trivial or insignificant blister on the side of the foot, as I initially, somewhat amused, thought. It is a structural change in the foot that requires care and attention to ensure and restore balanced mobility.

The excellent news is that you can take action to manage it yourself. Guidance and support for self-care can be sought from a physiotherapist. Surgical treatment is the absolute last resort, which must be carefully considered in collaboration with healthcare professionals.

The Development of a Bunion Is Linked to Functional Foot Disorders

After researching the topic, I, too, decided to consult a professional. Physiotherapist Terhi Jokela confirmed that there is no single reason why some of us develop a bunion while others do not. To determine the cause, a clinical examination by a physiotherapist is required.

Terhi explains that the development of a bunion is related to a functional disorder, where pressure is applied to a specific area of the foot, eventually leading to changes in the foot’s bone structure.

"In an ideal situation, the foot is balanced and rests on three points: under the ball of the big toe, under the ball of the outer edge of the foot, and in the center of the heel. A bunion develops when this triangular balance is disturbed, for example, due to ankle stiffness, causing the foot to bear excessive pressure in a single point.

This functional issue leads to structural changes in the foot. The bone structure at the base of the big toe shifts, and the joint protrudes outward. At the same time, the transverse arch under the ball of the foot flattens, leading to the widening of the foot."

In addition to functional problems, unsuitable shoes—such as high heels or those with narrow toe boxes—can also cause undesirable pressure on the foot. In my case, wearing high heels causes pain even after a short period of time, and they now mostly remain in my closet.

We women have the pleasure and honor of suffering from bunions more often than men. This may be partly due to genetic factors as well.

Understanding the Causes of the Condition Through a Physiotherapist's Examination

In my case, it is still a mild change. I can still walk and jog almost without pain, as long as I remember to wear good, well-fitting shoes. Nonetheless, Terhi’s examination was necessary to gain a clearer understanding of the condition of my foot and the functional issues that led to the development of the bunion.

The examination includes several components, such as assessing the function of the foot while standing still, performing deep squats, balancing on one leg, and toe raises. It also involves mobilizing the ankle joint to improve its mobility.

Indeed, the examination identified the causes of the condition, which also provides the basis for an individualized exercise program. I need to focus on expanding the range of motion in the lower ankle joint and strengthening the calf muscles.

I had even forgotten about a previous ankle ligament tear from my youth. Terhi noted that the restriction in the lower ankle joint’s range of motion might partly be due to this past injury.

Recovery Requires Personal Initiative

When it comes to recovery, it is crucial to perform and adhere to the prescribed exercises, which are often done daily or every few days.

In the past, much emphasis was placed solely on stretching, but recent research shows that combining stretching with muscle exercises for the legs and feet provides the best relief for the problems caused by a bunion.

For example, in my case, there is no need to stretch the calf muscle, but rather to strengthen it with exercises using a ball.

Now I have Terhi’s exercise program and instructions, which guide me in performing my daily exercises.