Cycling

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.

Surgical Treatment

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.

Since the bicycle's invention in the early 1900s, it has been a favorite form of recreation and sport in the U.S. More than 100 million Americans enjoy biking, either for recreation or, increasingly, for commuting to work each day. While a great workout for most of the body, feet play a vital role in cycling. They are responsible for the transfer of energy from the body to the pedals, which makes the bicycle move.

Keeping the alignment between the hips, knees, and feet is the most efficient way to operate a bicycle. Lack of proper body alignment and overactivity are responsible for the most common foot problems related to biking: Achilles tendonitis, sesamoiditis, shin splints, and foot numbness or pain.

Cycling Shoes

For the casual or recreational cyclist, a typical athletic shoe used for running, walking, or cross-training is perfectly fine for biking. Just be sure that the sole is firm and not worn down so that it grips the pedal to avoid slipping.

For more serious cyclists, next to bicycles themselves. proper shoes are the most important piece of cycling equipment. In general, cycling shoes should have a stiff sole and fit snugly around the bridge of the foot and heel. The more stable and less movement inside the shoe, the more power can be transferred through the entire foot to the pedal. Also look for shoes with ventilated uppers to keep feet more comfortable. Closure systems vary, including lacing, buckles, straps, and Velcro -- or some combination. You can choose whichever feel most comfortable to you. However, be careful that any loose ends (from straps or laces) and buckles don't hang over, as they can pose a safety hazard if you elect to use toe clips.

The type of biking you do can impact your choice of shoes as well. For road cycling and racing, shoes that have stiff soles, a narrow heel, and snug fit are best. For mountain biking, the shoes also need a decent tread for better grip and a more rugged sole.

Many serious cyclists use some form of a toe clip system. These allow the rider to transfer power from the body to the pedal in both the up and down motions of the leg. Simple toe clips have metal or plastic clips that attach to any type of shoe with strapping. However, they are not as efficient at energy transfer because they allow the foot to bend. Additionally, hanging straps can pose a danger. Clipless systems use metal or plastic cleats in the sole of a shoe that attach to bindings on the pedal. These are a good choice for road or race cycling, but they do take some adjusting to initially. Also, the cleats make the shoes unwearable for walking. Clips are generally not advised for mountain biking since the foot comes off the pedal frequently.

Remember to take the socks you plan to wear with you when trying on cycling shoes to make sure the fit is right.