A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes . The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Varus. Bunions can also lead to other toe deformities, such as hammertoe.
Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult--all contributing to chronic pain.
Bunions have been with mankind since the beginning of time. Undoubtedly they have received more attention since shoes have become a vital part of our fashion. It is generally recognized that those who have a bunion deformity most probably inherited the tendency from an earlier generation. So often people are told "don't have anything done until you can't stand the pain"! This is a misconception! Our rule of thumb is that when it becomes obvious that you have a bunion, that is the time to correct it!
Treatment for Bunions
Certainly the goal in bunion treatment is to limit the deformity and to stop the progression if it has already begun. This can only be done in the very beginning stages. When it is seen that the deformity is beginning in children and young adults, often the use of a good custom orthotic will stop the progression of the deformity. Also wearing shoes that do not irritate the deformity is also wise.
The greatest hurdle that people with bunion deformities have to overcome is history. In most instances, these people have had a relative with the same deformity who years ago had surgery and they remember the pain and the weeks and months in casts and on crutches. They also remember that after going through all of this pain and suffering, in many instances the bunion came back.
The good news is that in the past 10 years new techniques and better instrumentation have been developed. Bunion correction of today involves the use of micro instruments with precise cuts in the bone to correct the deformity, thus limiting the rate of re-occurrence. The old days of the doctor saying "I'm going to have to break the bone and reset" it are gone. If anyone says that to you, run as fast as you can! Gone are the days of casts and crutches and wheel chairs post-operatively. Only in the most severe cases must the patient be "non-weight bearing". In most cases, the patients at the Ford Center can resume a fairly normal lifestyle in days or weeks rather than months.
At the Ford Center for Foot Surgery, the procedures are done with I.V. sedation administered by one of our qualified anesthesiologists. We also use a regional anesthetic which is much safer than a general anesthetic. We can do this because we do not use tournequets when we do foot surgery. This minimizes post operative pain as well as the risk of blood clots. The net result of this is that the patient is awake and can walk within minutes following the surgery but their foot is numb for 18 - 20 hours.
The procedure itself is accomplished through an incision on the inside of the foot, thus there are no unsightly scars. The capsule of the joint is exposed and is opened revealing the "bump" on the side of the metatarsal bone. The over growth of bone is removed. Next a very precise "V" cut is made in the bone from one side to the other and the end or head of the bone is moved over. This narrows the foot back down to its normal width. To maintain this, a small screw is placed in the bone to secure the correction. The skin and soft tissues are then sutured and the foot bandaged. The foot is then placed in a post op shoe that will be worn for several weeks.
As a general rule, our patients return to comfortable shoes in 2 to 3 weeks.
More than 24 million people participate in some kind of aerobic exercise, which offers a host of health benefits, including increased cardiopulmonary efficiency, strengthened heart and lungs, improved circulation, lowered cholesterol levels, and stress and anxiety reduction.
Because aerobic exercise involves quick lateral movements, jumping, and leaping for extended periods of time, proper foot care plays a vital part in keeping the entire body fit. Common injuries from aerobics often involve the foot, ankle, and lower leg. Improper shoes, surfaces, or routines, and straining muscles by too vigorous a routine can lead to foot problems. Experts say that hardwood floors, especially with padded mats, are the best surfaces for your feet during aerobic exercise. And don't forget to stretch all the muscles, tendons, and ligaments in the leg, ankle, foot, and toes in a warm-up and cool-down periods before and after aerobics.
Proper shoes are crucial to successful, injury-free aerobics. Old sneakers in your closet are not the proper shoes for aerobics. Major shoe companies today have designed special shoes for aerobics, which provide the necessary arch and side support; they also have soles that allow for the twisting and turning of an aerobics regimen. Be aware that running shoes lack the necessary lateral stability and lift the heel too high to support aerobic activity. They also often have an acute outside flare that may put the athlete at greater risk of injury from the side-by-side motion in aerobics.
Aerobic shoes should provide sufficient cushioning and shock absorption to compensate for pressure on the foot many times greater than found in walking. They must also have good medial-lateral stability. Impact forces from aerobics can reach up to six times the force of gravity, which is transmitted to each of the 26 bones in the foot.
Because of the many side-to-side motions, aerobic shoes need an arch design that will compensate for these forces. Look for shoes with sufficiently thick upper leather or strap support to provide forefoot stability and prevent slippage of the foot and lateral shoe "breakup." Make sure shoes have a toe box that is high enough to prevent irritation of your toes and nails.
Two other tips: buy your aerobics shoes in the afternoon, when your feet swell slightly and wear the same socks (preferably made of an acrylic blend) that you will wear during aerobics.